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Are COX-2 inhibitors preferable to combined NSAID and PPI in countries with moderate health service expenditures?

Authorized Users Only
2010
Authors
Perić, Aneta
Toskić-Radojičić, Marija
Dobrić, Silva
Damjanov, Nemanja
Miljković, Branislava
Antunović, Mirjana
Vezmar, Sandra
Article (Published version)
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Abstract
Rationale In developed countries, cyclooxygenase 2 (COX-2) inhibitors were shown to be less costly than the combination of non-steroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs) in treatment of patients with high risk of serious gastrointestinal (GI) adverse effects. It is questionable if such results apply to developing countries where health service costs are lower and there is high discrepancy between generic and patent protected drug prices. We analysed the direct cost of treatment with generic NSAIDs in combination with PPIs versus branded COX-2 inhibitors in patients with high risk of serious GI adverse effects from the perspective of the public health service in Serbia. Methods Total cost of treatment of serious GI complications and the use of NSAID+PPI versus COX-2 inhibitors were calculated. A model for estimation of cost of treatment of NSAID+PPI versus COX-2 inhibitors which included the probability of developing serious GI adverse effects was devel...oped. Results Total cost of treatment of serious GI adverse effects resulted in an average of $814/patient. Considering the relative risk of such adverse effects for patients with four or more risk factors, the least costly treatment over 6 months was the use of celecoxib ($487). Compared with diclofenac+omeprazole, cost savings were estimated at $59 and $22 per patient with celecoxib and etoricoxib, respectively. Conclusion Cost savings may be achieved by using COX-2 inhibitors in patients at high risk of GI adverse effects even in countries with moderate health care service expenditures. Such possibility requires further investigation.

Keywords:
COX-2 inhibitors / gastrointestinal complications / non-steroidal anti-inflammatory drugs / pharmacoeconomics / proton pump inhibitors / treatment cost
Source:
Journal of Evaluation in Clinical Practice, 2010, 16, 6, 1090-1095
Publisher:
  • Wiley-Blackwell, Malden
Funding / projects:
  • Eksperimentalna i kliničko-farmakološka istraživanja mehanizma dejstva i interakcija lekova u nervnom i kardiovaskularnom sistemu (RS-145001)

DOI: 10.1111/j.1365-2753.2009.01258.x

ISSN: 1356-1294

PubMed: 20662999

WoS: 000285763900012

Scopus: 2-s2.0-78650606999
[ Google Scholar ]
1
1
URI
https://farfar.pharmacy.bg.ac.rs/handle/123456789/1366
Collections
  • Radovi istraživača / Researchers’ publications
Institution/Community
Pharmacy
TY  - JOUR
AU  - Perić, Aneta
AU  - Toskić-Radojičić, Marija
AU  - Dobrić, Silva
AU  - Damjanov, Nemanja
AU  - Miljković, Branislava
AU  - Antunović, Mirjana
AU  - Vezmar, Sandra
PY  - 2010
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/1366
AB  - Rationale In developed countries, cyclooxygenase 2 (COX-2) inhibitors were shown to be less costly than the combination of non-steroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs) in treatment of patients with high risk of serious gastrointestinal (GI) adverse effects. It is questionable if such results apply to developing countries where health service costs are lower and there is high discrepancy between generic and patent protected drug prices. We analysed the direct cost of treatment with generic NSAIDs in combination with PPIs versus branded COX-2 inhibitors in patients with high risk of serious GI adverse effects from the perspective of the public health service in Serbia. Methods Total cost of treatment of serious GI complications and the use of NSAID+PPI versus COX-2 inhibitors were calculated. A model for estimation of cost of treatment of NSAID+PPI versus COX-2 inhibitors which included the probability of developing serious GI adverse effects was developed. Results Total cost of treatment of serious GI adverse effects resulted in an average of $814/patient. Considering the relative risk of such adverse effects for patients with four or more risk factors, the least costly treatment over 6 months was the use of celecoxib ($487). Compared with diclofenac+omeprazole, cost savings were estimated at $59 and $22 per patient with celecoxib and etoricoxib, respectively. Conclusion Cost savings may be achieved by using COX-2 inhibitors in patients at high risk of GI adverse effects even in countries with moderate health care service expenditures. Such possibility requires further investigation.
PB  - Wiley-Blackwell, Malden
T2  - Journal of Evaluation in Clinical Practice
T1  - Are COX-2 inhibitors preferable to combined NSAID and PPI in countries with moderate health service expenditures?
VL  - 16
IS  - 6
SP  - 1090
EP  - 1095
DO  - 10.1111/j.1365-2753.2009.01258.x
UR  - conv_2379
ER  - 
@article{
author = "Perić, Aneta and Toskić-Radojičić, Marija and Dobrić, Silva and Damjanov, Nemanja and Miljković, Branislava and Antunović, Mirjana and Vezmar, Sandra",
year = "2010",
abstract = "Rationale In developed countries, cyclooxygenase 2 (COX-2) inhibitors were shown to be less costly than the combination of non-steroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs) in treatment of patients with high risk of serious gastrointestinal (GI) adverse effects. It is questionable if such results apply to developing countries where health service costs are lower and there is high discrepancy between generic and patent protected drug prices. We analysed the direct cost of treatment with generic NSAIDs in combination with PPIs versus branded COX-2 inhibitors in patients with high risk of serious GI adverse effects from the perspective of the public health service in Serbia. Methods Total cost of treatment of serious GI complications and the use of NSAID+PPI versus COX-2 inhibitors were calculated. A model for estimation of cost of treatment of NSAID+PPI versus COX-2 inhibitors which included the probability of developing serious GI adverse effects was developed. Results Total cost of treatment of serious GI adverse effects resulted in an average of $814/patient. Considering the relative risk of such adverse effects for patients with four or more risk factors, the least costly treatment over 6 months was the use of celecoxib ($487). Compared with diclofenac+omeprazole, cost savings were estimated at $59 and $22 per patient with celecoxib and etoricoxib, respectively. Conclusion Cost savings may be achieved by using COX-2 inhibitors in patients at high risk of GI adverse effects even in countries with moderate health care service expenditures. Such possibility requires further investigation.",
publisher = "Wiley-Blackwell, Malden",
journal = "Journal of Evaluation in Clinical Practice",
title = "Are COX-2 inhibitors preferable to combined NSAID and PPI in countries with moderate health service expenditures?",
volume = "16",
number = "6",
pages = "1090-1095",
doi = "10.1111/j.1365-2753.2009.01258.x",
url = "conv_2379"
}
Perić, A., Toskić-Radojičić, M., Dobrić, S., Damjanov, N., Miljković, B., Antunović, M.,& Vezmar, S.. (2010). Are COX-2 inhibitors preferable to combined NSAID and PPI in countries with moderate health service expenditures?. in Journal of Evaluation in Clinical Practice
Wiley-Blackwell, Malden., 16(6), 1090-1095.
https://doi.org/10.1111/j.1365-2753.2009.01258.x
conv_2379
Perić A, Toskić-Radojičić M, Dobrić S, Damjanov N, Miljković B, Antunović M, Vezmar S. Are COX-2 inhibitors preferable to combined NSAID and PPI in countries with moderate health service expenditures?. in Journal of Evaluation in Clinical Practice. 2010;16(6):1090-1095.
doi:10.1111/j.1365-2753.2009.01258.x
conv_2379 .
Perić, Aneta, Toskić-Radojičić, Marija, Dobrić, Silva, Damjanov, Nemanja, Miljković, Branislava, Antunović, Mirjana, Vezmar, Sandra, "Are COX-2 inhibitors preferable to combined NSAID and PPI in countries with moderate health service expenditures?" in Journal of Evaluation in Clinical Practice, 16, no. 6 (2010):1090-1095,
https://doi.org/10.1111/j.1365-2753.2009.01258.x .,
conv_2379 .

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