Cost-effectiveness analysis for joint pain treatment in patients with osteoarthritis treated at the Instituto Mexicano del Seguro Social (IMSS): Comparison of nonsteroidal anti-inflammatory drugs (NSAIDs) vs. cyclooxygenase-2 selective inhibitors

Abstract

Background: Osteoarthritis (OA) is one of the main causes of disability worldwide, especially in persons >55 years of age. Currently, controversy remains about the best therapeutic alternative for this disease when evaluated from a cost-effectiveness viewpoint. For Social Security Institutions in developing countries, it is very important to assess what drugs may decrease the subsequent use of medical care resources, considering their adverse events that are known to have a significant increase in medical care costs of patients with OA. Three treatment alternatives were compared: celecoxib (200 mg twice daily), non-selective NSAIDs (naproxen, 500 mg twice daily; diclofenac, 100 mg twice daily; and piroxicam, 20 mg/day) and acetaminophen, 1000 mg twice daily. The aim of this study was to identify the most cost-effective first-choice pharmacological treatment for the control of joint pain secondary to OA in patients treated at the Instituto Mexicano del Seguro Social (IMSS).

A Review of the Efficacy, Safety, and Cost‐Effectiveness of COX‐2 Inhibitors for Africa and the Middle East Region

“…Treatment of chronic musculoskeletal pain syndromes, such as OA and RA, is costly. A recent cost‐effectiveness study conducted in Mexico showed that healthcare cost of OA over a 6‐month period averaged as much as MXP 5,051.84 (∼USD 421; ∼12 MXP to 1 USD) 111 . Mean annual direct medical cost of RA, as calculated from a literature review of RA economic studies, was estimated to be USD 5,720, whereas mean annual indirect cost was calculated to be USD 5,822 112 …”

“…An important driver of increased healthcare costs for patients with arthritis is the treatment of adverse events associated with the use of nsNSAIDs 111 . It has been consistently documented that medical consultations, need for hospitalization and the use of concomitant drugs are increased in this population.…”

“…Data from cost‐effectiveness studies indicate that cost savings may be achieved by using celecoxib in arthritis patients, especially those at moderate to high risk of gastrointestinal adverse events. As a result of its superior gastrointestinal safety and tolerability profile, celecoxib has been shown to reduce gastrointestinal healthcare resource utilization compared with nsNSAIDs 111,113–117 . Specifically, celecoxib was associated with a reduction in the number of hospitalizations for upper gastrointestinal events (including hemorrhage), intensive care unit admissions, physician and specialist visits, and blood transfusions.…”

Safety Profile of Current OA Therapies: Evidence from Clinical Trials

“…Starting with Maetzel et al [ 2 ], CV events began to be modeled, with myocardial infarction (MI) modeled fi rst. Schaefer et al [ 3 ] was the fi rst to add congestive heart failure (CHF), and Contreras-Hernandez et al the fi rst to add stroke [ 4 ]. Both Schaefer et al and Contreras-Hernandez et al also included renal failure as an event.…”

Hyperlipidemic microenvironment conditionates damage mechanisms in human chondrocytes by oxidative stress

“…OA is one of the most common musculoskeletal disorders of the aging population [1–3], and a leading cause of chronic disability. A great variety of risk factors contributes to the development of OA such as age, gender, joint trauma, genetic factors, excessive joint usage (such as physical cartilage-overload) and particularly obesity [4, 5].…”