Assessing the cost-effectiveness of COX-2 specific inhibitors for arthritis in the Veterans Health Administration

Schaefer, Monica; DeLattre, Melissa L.; Gào, Xīn; Stephens, Jennifer; Botteman, Marc; Morreale, Anthony P.

doi:10.1185/030079904x17974

Cited by 16 publications

(7 citation statements)

References 28 publications

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“…This finding enriches our understanding of the tumorigenic pathway that leads to esophageal cancer growth. As mentioned earlier, prostaglandin pathway remains one of the well validated pathway for drug development for chemoprevention, but COX-2 specific inhibitors has formidable cardiovascular effects that has prohibited their widespread use (McKenna et al, 2001;Solomon et al, 2004;Wolfe et al, 2004;Zhao et al, 2004;Schaefer et al, 2005;O'Kane et al, 2010). On the other hand, it will be of enormous clinical benefit if PGDH expression can be induced in premalignant and malignant epithelial cells in esophageal cancer and subsequently suppress tumor growth.…”

Section: Discussionmentioning

confidence: 99%

Expression of PGDH Correlates with Cell Growth in Both Esophageal Squamous Cell Carcinoma and Adenocarcinoma

Yang

Wang²,

Xu³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Esophageal cancer represents the fourth most common gastrointestinal cancer and generally confers a poor prognosis. Prostaglandin-producing cyclo-oxygenase has been implicated in the pathogenesis of esophageal cancer growth. Here we report that prostaglandin dehydrogenase, the major enzyme responsible for prostaglandin degradation, is significantly reduced in expression in esophageal cancer in comparison to normal esophageal tissue. Reconstitution of PGDH expression in esophageal cancer cells suppresses cancer cell growth, at least in part through preventing cell proliferation and promoting cell apoptosis. The tumor suppressive role of PGDH applies equally to both squamous cell carcinoma and adenocarcinoma, which enriches our understanding of the pathogenesis of esophageal cancer and may provide an important therapeutic target.

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Section: Discussionmentioning

confidence: 99%

Expression of PGDH Correlates with Cell Growth in Both Esophageal Squamous Cell Carcinoma and Adenocarcinoma

Yang

Wang²,

Xu³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…Consequently, the cost per QALY gained was less than US$50,000 with celecoxib, while treatment with rofecoxib was more expensive and associated with net QALY loss. 32 The other strength of this analysis is the period of 6 months for base case analysis. As OA is a chronic condition, patients use pain medications over long periods of time.…”

Section: Discussionmentioning

confidence: 99%

The Cost-effectiveness of Celecoxib versus Non-steroidal Anti-inflammatory Drugs plus Proton-pump Inhibitors for Treating Osteoarthritis in Algeria

Hammoumraoui

Kherraf²,

Mould-Quevedo

et al. 2013

JHEOR

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Background: Cyclooxygenase-2 inhibitors such as celecoxib are as effective as non-selective non-steroidal anti-inflammatory drugs (ns-NSAIDs) in the treatment of osteoarthritis (OA), have fewer gastrointestinal side effects, but are more expensive. Objective: To evaluate the incremental cost-effectiveness ratio (ICER) of celecoxib versus ns-NSAIDs, with/without proton-pump inhibitor (PPI) co-therapy, for treating OA in Algeria. Methods: The National Institute for Health and Clinical Excellence (NICE) health economic model from UK, updated with relative risks of adverse events using CONDOR trial data, was adapted for costeffectiveness analysis in OA patients aged ≥65 years. Patients could initiate treatment with celecoxib or ns-NSAIDs with/without omeprazole. Conditional probabilities were obtained from published clinical trials; effectiveness measure was quality-adjusted life years (QALYs) gained/patient. The analysis was conducted from a healthcare payer’s perspective. The average daily treatment costs and frequencies of resource use for adverse events were based on data collected in August 2011 from a private clinic located in Cheraga, Algiers, Algeria. Probabilistic sensitivity analysis (PSA) was performed to construct cost-effectiveness acceptability curves (CEACs). Results: QALYs gained/patient over a 6-month horizon were higher with celecoxib (0.368) and celecoxib+PPI (0.40) versus comparators. The lowest expected cost/patient was associated with ibuprofen (US$134.76 versus US$175.67 with celecoxib+PPI, and US$177.57 with celecoxib). Celecoxib+PPI was the most cost-effective drug treatment, with an ICER of US$584.43, versus ibuprofen. Treatment with celecoxib alone showed an ICER of US$1,530.56 versus diclofenac+PPI. These ICERs are <1 gross domestic product per capita in Algeria (US$7,500). Over 1-year, 3-year and 5-year horizons, celecoxib with/without PPI co-therapy showed higher QALYs/patient versus comparators, and decreasing ICERs. The ICER of celecoxib+PPI was lower than that of comparators over all time horizons. These findings were confirmed with CEACs generated via PSA. Conclusion: Using data from a single private clinic in Cheraga, Algiers, Algeria, and after considering new adverse event risks, we showed that celecoxib with/without PPI co therapy is more cost-effective than ns-NSAID+PPI for treating OA patients aged ≥65 years. Celecoxib+PPI remains dominant over a 5-year horizon, making it the most cost-effective treatment option for medium- and long-term use.

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“…However, 5 of these studies with a similar evaluation framework incorporate nsNSAID ulcer probabilities considerably higher than those in the major trials, and international differences in drug prices and health system costs also limit the scope for generalizing these findings to other countries [16,21,22]. Two American studies suggest that celecoxib may be cost-effective compared with an nsNSAID [86,87]. …”

Section: Discussionmentioning

confidence: 99%

An economic model of long-term use of celecoxib in patients with osteoarthritis

2007

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Background: Previous evaluations of the cost-effectiveness of the cyclooxygenase-2 selective inhibitor celecoxib (Celebrex, Pfizer Inc, USA) have produced conflicting results. The recent controversy over the cardiovascular (CV) risks of rofecoxib and other coxibs has renewed interest in the economic profile of celecoxib, the only coxib now available in the United States. The objective of our study was to evaluate the long-term cost-effectiveness of celecoxib compared with nonselective nonsteroidal anti-inflammatory drugs (nsNSAIDs) in a population of 60-year-old osteoarthritis (OA) patients with average risks of upper gastrointestinal (UGI) complications who require chronic daily NSAID therapy.

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Assessing the cost-effectiveness of COX-2 specific inhibitors for arthritis in the Veterans Health Administration

Cited by 16 publications

References 28 publications

Expression of PGDH Correlates with Cell Growth in Both Esophageal Squamous Cell Carcinoma and Adenocarcinoma

Expression of PGDH Correlates with Cell Growth in Both Esophageal Squamous Cell Carcinoma and Adenocarcinoma

The Cost-effectiveness of Celecoxib versus Non-steroidal Anti-inflammatory Drugs plus Proton-pump Inhibitors for Treating Osteoarthritis in Algeria

An economic model of long-term use of celecoxib in patients with osteoarthritis

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