ECONOMIC-EVALUATION OF GASTRIC-ULCER PROPHYLAXIS IN PATIENTS WITH ARTHRITIS RECEIVING NONSTEROIDAL ANTIINFLAMMATORY DRUGS

This study assesses the economic benefits of misoprostol in the prophylaxis of gastric ulcers larger than 0.3 cm in patients with osteoarthritis receiving non-steroidal anti-inflammatory drugs. Independent epidemiological data were obtained for patients in Scotland and the West Midlands. Co-diagnosis of arthritis with gastric ulcer recorded in the routine data was substantially less (4% Scotland, 10% West Midlands) than the 21% found at case review. These data were combined with cost and patient management data in a decision analysis model to explore whether prophylactic use of misoprostol altered substantially the average cost of managing gastric ulcer. Using conservative assumptions and a daily dose of 400 fg, cost savings per patient to the National Health Service of £5-£8 over a 3-month period are expected in the groups of patients studied, while at the 800 gig dose there would be a net cost of £23-£25. Sensitivity analysis showed that under many assumptions misoprostol is expected to be cost saving or cost neutral.