Xueshan Sun1, Xuemei Zhen2,3, Xiaoqian Hu1, Yuanyuan Li1, ShuYan Gu4, Yuxuan Gu1, Zixuan Zhao1, Wei Yang5, Hengjin Dong6,7. 1. Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Zijingang Campus, Rd 866 Yuhang, Xihu District, Hangzhou, Zhejiang, China. 2. School of Health Care Management, Shandong University, 44 Wenhuaxi Rd., Jinan, Shandong, China. 3. NHC Key Laboratory of Health Economics and Policy Research (Shandong University), 44 Wenhuaxi Rd., Jinan, Shandong, China. 4. Center for Health Policy and Management Studies, School of Government, Nanjing University, Nanjing, Jiangsu, China. 5. Shanghai Suvalue Health Scienfific Ltd., Shanghai, China. 6. Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Zijingang Campus, Rd 866 Yuhang, Xihu District, Hangzhou, Zhejiang, China. donghj@zju.edu.cn. 7. The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, Zhejiang, China. donghj@zju.edu.cn.
Abstract
BACKGROUND: To estimate the cost -utility of imrecoxib compared with diclofenac, as well as the addition of a proton pump inhibitor to both two treatment strategies, for patients with osteoarthritis, from a Chinese healthcare perspective. METHODS: A Markov model was built. Costs of managing osteoarthritis and initial adverse events were collected from a Medical Database which collected information from 170 hospitals. Other parameters were obtained from the literature. Subgroup analyses were conducted for people at high risk of gastrointestinal or cardiovascular adverse events. Deterministic and probabilistic sensitivity analyses were performed. RESULTS: Imrecoxib was highly cost-effective than diclofenac (the ICER was $401.58 and $492.77 in patients at low and high gastrointestinal and cardiovascular risk, respectively). The addition of a proton pump inhibitor was more cost -effective compared with single drug for both treatment strategies. Findings remained robust to sensitivity analyses. 59.04% and 57.16% probability for the co-prescription of imrecoxib and a proton pump inhibitor to be the most cost-effective strategy in all patients considered using the cost-effectiveness threshold of $30,000. CONCLUSIONS: The addition of a proton pump inhibitor to both imrecoxib and diclofenac was advised. Imrecoxib provides a valuable option for patients with osteoarthritis. Uncertainties existed in the model, and the suggestions can be adopted with caution.
BACKGROUND: To estimate the cost -utility of imrecoxib compared with diclofenac, as well as the addition of a proton pump inhibitor to both two treatment strategies, for patients with osteoarthritis, from a Chinese healthcare perspective. METHODS: A Markov model was built. Costs of managing osteoarthritis and initial adverse events were collected from a Medical Database which collected information from 170 hospitals. Other parameters were obtained from the literature. Subgroup analyses were conducted for people at high risk of gastrointestinal or cardiovascular adverse events. Deterministic and probabilistic sensitivity analyses were performed. RESULTS:Imrecoxib was highly cost-effective than diclofenac (the ICER was $401.58 and $492.77 in patients at low and high gastrointestinal and cardiovascular risk, respectively). The addition of a proton pump inhibitor was more cost -effective compared with single drug for both treatment strategies. Findings remained robust to sensitivity analyses. 59.04% and 57.16% probability for the co-prescription of imrecoxib and a proton pump inhibitor to be the most cost-effective strategy in all patients considered using the cost-effectiveness threshold of $30,000. CONCLUSIONS: The addition of a proton pump inhibitor to both imrecoxib and diclofenac was advised. Imrecoxib provides a valuable option for patients with osteoarthritis. Uncertainties existed in the model, and the suggestions can be adopted with caution.