Se. Gabriel et al., A COST-UTILITY ANALYSIS OF MISOPROSTOL PROPHYLAXIS FOR RHEUMATOID-ARTHRITIS PATIENTS RECEIVING NONSTEROIDAL ANTIINFLAMMATORY DRUGS, Arthritis and rheumatism, 37(3), 1994, pp. 333-341
Objective. To determine the cost-utility of low-dose misoprostol proph
ylaxis in rheumatoid arthritis (RA) patients treated with nonsteroidal
antiinflammatory drugs (NSAIDs). Methods. Prospectively collected, po
pulation-based data on 57 RA patients' preferences (obtained using the
category scaling and time trade-off techniques), charge data from a c
onsecutive, population-based cohort of 36 RA patients with NSAID-relat
ed gastric ulcer, and literature-derived probability estimates were in
corporated into a decision analysis model. Results. Probabilistic sens
itivity analysis using 10,000 Monte Carlo simulations demonstrated tha
t, on average, prophylaxis resulted in modest additional costs and no
additional quality-of-life benefits. At best, the incremental cost per
quality-adjusted life year gained was $9,333. At worst, prophylaxis r
educed quality of life. Prophylaxis was cost-saving if the ulcer compl
ication rate was >1.5%, or if the 3-month price of misoprostol was les
s than or equal to$95.