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KMID : 1146320150030010017
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Journal of Health Technology Assessment
2015 Volume.3 No. 1 p.17 ~ p.25
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The Cost Effectiveness of Celecoxib versus Diclofenac and Omeprazole in Patients with Osteoarthritis or Rheumatoid Arthritis
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Park Da-Jin
Lee Youn-Joo
Hwang Sung-Hye
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Abstract
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Objectives: The aim of this study is to analyze cost-effectiveness of celecoxib monotherapy versus diclofenac and omeprazole combination therapy for osteoarthritis or rheumatoid arthritis patients in Korea.
Methods: A 6-month decision tree model was developed from the limited societal perspective. The main efficacy probabilities were derived from the CONDOR trial which studied the efficacy and adverse event rates for rheumatoid arthritis and osteoarthritis patients with the use of non-steroidal anti-inflammatory drugs. The model was conducted on a 3-month cycle until the first event and one-month cycle thereafter. Gastrointestinal event rates were applied along with mortality and utility values to get the final results. Costs included medications, monitoring and treatment costs for adverse events. All cost information was obtained from Korea-specific data sources. Sensitivity analysis was conducted to reflect compliance rate, patient age and celecoxib price change according to the current drug pricing policy in Korea.
Results: The final cost and quality-adjusted life year (QALY) of celecoxib was 409591 KRW with 0.43064 QALY and 426645 KRW with 0.42539 QALY for diclofenac plus omeprazole. The celecoxib total cost was less costly than diclofenanc plus omeprazole while it yielded more QALY gained, thus celcecoxib was a dominant treatment option. Sensitivity analysis results were robust and proved celecoxib was cost effective.
Conclusion: Celecoxib can be considered as a cost-effective measure compared to difclofenac plus omeprazole therapy in patients with osteoarthritis and rheumatoid arthritis.
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KEYWORD
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Celecoxib, NSAID, Diclofenac, Cost-effectiveness analysis, RA, OA, Incremental cost effectiveness ratio
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