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

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-effecti...

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Autores principales: Hammoumraoui, Nadir, Kherraf, Sid Ahmed, Mould-Quevedo, Joaquin, Ismail, Tarek A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Columbia Data Analytics, LLC 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471414/
https://www.ncbi.nlm.nih.gov/pubmed/37662022
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author Hammoumraoui, Nadir
Kherraf, Sid Ahmed
Mould-Quevedo, Joaquin
Ismail, Tarek A.
author_facet Hammoumraoui, Nadir
Kherraf, Sid Ahmed
Mould-Quevedo, Joaquin
Ismail, Tarek A.
author_sort Hammoumraoui, Nadir
collection PubMed
description 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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spelling pubmed-104714142023-09-01 The Cost-effectiveness of Celecoxib versus Non-steroidal Anti-inflammatory Drugs plus Proton-pump Inhibitors for Treating Osteoarthritis in Algeria Hammoumraoui, Nadir Kherraf, Sid Ahmed Mould-Quevedo, Joaquin Ismail, Tarek A. J Health Econ Outcomes Res Autoimmune Diseases 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. Columbia Data Analytics, LLC 2013-10-07 /pmc/articles/PMC10471414/ /pubmed/37662022 Text en https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (4.0) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Autoimmune Diseases
Hammoumraoui, Nadir
Kherraf, Sid Ahmed
Mould-Quevedo, Joaquin
Ismail, Tarek A.
The Cost-effectiveness of Celecoxib versus Non-steroidal Anti-inflammatory Drugs plus Proton-pump Inhibitors for Treating Osteoarthritis in Algeria
title The Cost-effectiveness of Celecoxib versus Non-steroidal Anti-inflammatory Drugs plus Proton-pump Inhibitors for Treating Osteoarthritis in Algeria
title_full The Cost-effectiveness of Celecoxib versus Non-steroidal Anti-inflammatory Drugs plus Proton-pump Inhibitors for Treating Osteoarthritis in Algeria
title_fullStr The Cost-effectiveness of Celecoxib versus Non-steroidal Anti-inflammatory Drugs plus Proton-pump Inhibitors for Treating Osteoarthritis in Algeria
title_full_unstemmed The Cost-effectiveness of Celecoxib versus Non-steroidal Anti-inflammatory Drugs plus Proton-pump Inhibitors for Treating Osteoarthritis in Algeria
title_short The Cost-effectiveness of Celecoxib versus Non-steroidal Anti-inflammatory Drugs plus Proton-pump Inhibitors for Treating Osteoarthritis in Algeria
title_sort cost-effectiveness of celecoxib versus non-steroidal anti-inflammatory drugs plus proton-pump inhibitors for treating osteoarthritis in algeria
topic Autoimmune Diseases
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471414/
https://www.ncbi.nlm.nih.gov/pubmed/37662022
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