Re. Johnson et al., ANALYSIS OF THE COSTS OF NSAID-ASSOCIATED GASTROPATHY - EXPERIENCE INA US HEALTH MAINTENANCE ORGANIZATION, PharmacoEconomics, 12(1), 1997, pp. 76-88
Clinicians recognise nonsteroidal anti-inflammatory drugs (NSAIDs) as
valuable first-line agents in the treatment of rheumatic disorders and
as dangerous irritants to the gastrointestinal tract. This has led to
questions about the economic impact of NSAID-induced gastropathy in p
opulations. This study estimated the 1992 costs of NSAID-associated ga
stropathy episodes, and calculated an iatrogenic cast factor for NSAID
-associated gastropathy among elderly members of a health maintenance
organisation (HMO), the Northwest Region of Kaiser Permanente. Using d
ata retrieved from automated databases and from medical records, NSAID
and antiulcer drug costs were calculated, and estimates were made of
the incidence rates of inpatient and outpatient NSAID-associated gastr
opathies, the services provided to treat them, and the cost of those s
ervices. Kaiser Permanente Northwest spent $US0.35 for each $US1.00 sp
ent on NSAID therapy for the elderly, an iatrogenic cost factor of 1.3
5. The estimated average treatment per NSAID-associated gastropathy ep
isode was $US2172. The average outpatient pharmacy cost per elderly NS
AID user was $US80 and estimated average NSAID-associated treatment co
st per elderly NSAID user was $US43. Although the findings were specif
ic to the HMO because of the databases used, the methodology employed
and the drug formulary influence on NSAID selection, they show that a
substantial amount of resources were used to treat NSAID-induced gastr
opathies in the elderly, underscoring the risk of prescribing NSAIDs a
nd reinforcing the need for their prudent use in elderly patients.