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dc.creatorPerić, Aneta
dc.creatorToskić-Radojičić, Marija
dc.creatorDobrić, Silva
dc.creatorDamjanov, Nemanja
dc.creatorMiljković, Branislava
dc.creatorAntunović, Mirjana
dc.creatorVezmar, Sandra
dc.date.accessioned2019-09-02T11:20:58Z
dc.date.available2019-09-02T11:20:58Z
dc.date.issued2010
dc.identifier.issn1356-1294
dc.identifier.urihttp://farfar.pharmacy.bg.ac.rs/handle/123456789/1366
dc.description.abstractRationale 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.en
dc.publisherWiley-Blackwell, Malden
dc.relationinfo:eu-repo/grantAgreement/MESTD/MPN2006-2010/145001/RS//
dc.rightsrestrictedAccess
dc.sourceJournal of Evaluation in Clinical Practice
dc.subjectCOX-2 inhibitorsen
dc.subjectgastrointestinal complicationsen
dc.subjectnon-steroidal anti-inflammatory drugsen
dc.subjectpharmacoeconomicsen
dc.subjectproton pump inhibitorsen
dc.subjecttreatment costen
dc.titleAre COX-2 inhibitors preferable to combined NSAID and PPI in countries with moderate health service expenditures?en
dc.typearticle
dc.rights.licenseARR
dcterms.abstractДобрић, Силва; Aнтуновић, Мирјана; Перић, Aнета; Везмар, Сандра; Дамјанов, Немања; Миљковић, Бранислава; Тоскић-Радојичић, Марија;
dc.citation.volume16
dc.citation.issue6
dc.citation.spage1090
dc.citation.epage1095
dc.citation.other16(6): 1090-1095
dc.citation.rankM22
dc.identifier.wos000285763900012
dc.identifier.doi10.1111/j.1365-2753.2009.01258.x
dc.identifier.pmid20662999
dc.identifier.scopus2-s2.0-78650606999
dc.identifier.rcubconv_2379
dc.type.versionpublishedVersion


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