Analysis of cost-minimization treatment with paracetamol or COX-2 inhibitors (rofecoxib) for pain from arthrosis of the knee or hip

• Published in: Atención primaria 2004-12, Vol.34 (10), p.534
• Main Authors: Lizán Tudela, L, Magaz Marqués, S, Varela Moreno, C, Riesgo Bucher, Y
• Format: Article
• Language: Spanish
• Subjects: Acetaminophen - economics; Acetaminophen - therapeutic use; Analgesics, Non-Narcotic - economics; Analgesics, Non-Narcotic - therapeutic use; Costs and Cost Analysis; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Cyclooxygenase Inhibitors - economics; Cyclooxygenase Inhibitors - therapeutic use; Decision Trees; Hip Joint; Humans; Joint Diseases - complications; Joint Diseases - drug therapy; Knee Joint; Lactones - economics; Lactones - therapeutic use; Membrane Proteins; Pain - drug therapy; Pain - etiology; Prostaglandin-Endoperoxide Synthases; Severity of Illness Index; Sulfones - economics; Sulfones - therapeutic use
• ISSN: 0212-6567

To assess the efficiency of paracetamol, indicated in first instance for light-to-moderate pain from hip and knee arthrosis, against rofecoxib, the COX-2 inhibitor most commonly used in Spain. Pharmaco-economic model: cost-minimisation analysis based on the information provided by a systematic review of the literature. Spain: statewide. Patients with a diagnosis of knee or hip arthrosis, who demand health-care for light-to-moderate pain in the primary care services and present no counter-indication to the treatments under evaluation. Given the supposition of the equivalent efficacy of paracetamol and rofecoxib, the cost-minimisation model focused on the cost arising from the adverse side effects caused by the 2 drugs. A correction factor allowed for the number of subjects in the studies reviewed and the number of adverse side effects found. Paracetamol was cheaper than rofecoxib at both 3 months and 1 year. The average cost of paracetamol per year was 307.95 Euros (301.57-315.12) versus 574.59 Euros (566.74-580.40) for rofecoxib treatment. The main cause of costs after the sensitivity analysis was the cost of acquiring the drugs, rather than the rate of incidence of adverse side effects. In terms of economic analysis based on cost minimisation, paracetamol was the first-preference treatment over rofecoxib for light-to-moderate arthrosis pain. This confirmed the recommendations which, under efficacy and safety criteria, are indicated in various clinical practice guidelines in force.