Authors: Davey P.J.¹; Meyer E.²

Source: PharmacoEconomics, Volume 17, Number 3, 1 March 2000 , pp. 295-304(10)

Publisher: Adis International

Abstract:

Objective: This study considered the cost effectiveness of misoprostol prophylaxis for nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal damage, using data from the Misoprostol Ulcer Complications Outcomes Safety Assessment (MUCOSA) trial. The initial aim was to gain listing of misoprostol on the Australian National Formulary.

Design: The economic evaluation followed a 2-stage approach in considering the cost effectiveness of misoprostol, a ‘within-trial’ analysis followed by a simple modelled analysis which explored the implications of the trial results for life-years saved beyond the trial setting. The perspective of the evaluation is that of the healthcare system.

Setting: Three different populations were considered: the total trial population; patients with a history of peptic ulcer disease; and patients over 65 years of age.

Study population: Patient data were taken from the MUCOSA trial, which involved 8843 patients receiving continuous NSAID therapy for the control of rheumatoid arthritis.

Interventions: Misoprostol plus any NSAID therapy was compared with placebo (no misoprostol) plus any NSAID therapy.

Main outcome measures and results: The study found the incremental cost per definite serious gastrointestinal complication avoided with misoprostol was 39 603 Australian dollars ($A) for the total trial population, $A5599 for patients with a history of peptic ulcer disease and $A35 405 for patients over 65 years of age. The incremental cost per life-year saved with misoprostol was $A41 866 for the whole group, $A6244 for patients with a history of peptic ulcer disease and $A40 322 for patients over 65 years of age.

Conclusions: The study found misoprostol to be cost effective in this setting.

Keywords: Antiulcers, therapeutic use; Cost effectiveness; Misoprostol, therapeutic use; NSAID induced gastrointestinal damage, prevention; Pharmacoeconomics

Document Type: Original article

Affiliations: 1: M-TAG Pty Ltd, Chatswood, New South Wales, Australia 2: Searle - A Division of Monsanto Australia Ltd, Crows Nest, New South Wales, Australia

Publication date: 2000-03-01

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