| Title: |
Therapy switching and associated costs in elderly patients receiving COX-2 selective inhibitors or non-selective non-steroidal anti-inflammatory drugs in Quebec, Canada |
| Authors: |
Rahme, E.; Toubouti, Y.; Hunsche, E. |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2006 |
| Collection: |
HighWire Press (Stanford University) |
| Subject Terms: |
Original Papers |
| Description: |
Objectives . Lack of efficacy or tolerability of some non-steroidal anti-inflammatory drugs (NSAIDs) may lead to switching between non-selective NSAIDs (nsNSAIDs) and cyclooxygenase-2 (COX-2) selective inhibitors (coxibs), potentially increasing treatment costs due to additional physician visits and wastage of medication. This study assessed drug switching and associated costs among elderly chronic NSAID users. Methods . Data for patients who filled their first prescription for a coxib or nsNSAID in 2001 were obtained from the Quebec Health Insurance Agency. Follow-up was terminated at the earliest of: 1 yr, the first day without NSAID exposure following the index filling date, or death. Patients could switch NSAIDs several times during follow-up. Person-days of exposure were categorized by the NSAID most recently dispensed: rofecoxib, celecoxib, Arthrotec® or non-Arthrotec (nA) nsNSAID. Cox regression models compared time to switch between groups, adjusting for patient baseline characteristics. Upon a switch, pills remaining from the previous prescription were considered wasted. The costs of wasted pills and switch-associated physician visits were estimated. Results . Throughout follow-up, patients filled 38 267 prescriptions for rofecoxib, 31 282 for celecoxib, 1108 for Arthrotec and 4388 for nA-nsNSAIDs. Adjusted hazard ratios (95% confidence interval) for switching versus nA-nsNSAIDs were: rofecoxib, 0.39 (0.35-0.44); celecoxib, 0.43 (0.38-0.48). Compared with nA-nsNSAID prescriptions, adjusted switching-related healthcare costs were 53 and 47% lower on average for rofecoxib and celecoxib prescriptions, respectively. These costs were 34% higher for Arthrotec prescriptions than for nA-nsNSAIDs. Conclusions . Compared with recipients of nsNSAIDs, coxib recipients were less likely to switch medications and had approximately half the adjusted costs for switching-related wasted resources per prescription. |
| Document Type: |
text |
| File Description: |
text/html |
| Language: |
English |
| Relation: |
http://rheumatology.oxfordjournals.org/cgi/content/short/kei269v1; http://dx.doi.org/10.1093/rheumatology/kei269 |
| DOI: |
10.1093/rheumatology/kei269 |
| Availability: |
http://rheumatology.oxfordjournals.org/cgi/content/short/kei269v1; https://doi.org/10.1093/rheumatology/kei269 |
| Rights: |
Copyright (C) 2006, British Society for Rheumatology |
| Accession Number: |
edsbas.13694D56 |
| Database: |
BASE |