File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: An economic evaluation of enteric-coated and standard formulations of naproxen from a gastrointestinal perspective

TitleAn economic evaluation of enteric-coated and standard formulations of naproxen from a gastrointestinal perspective
Authors
KeywordsCost of treatment
Economic evaluation
Enteric-coated NSAID
Gastrointestinal side effects
General practice
Naprosyn
Naproxen
Referral rates
Sensitivity analysis
Treatment patterns
Issue Date1994
PublisherInforma Healthcare. The Journal's web site is located at http://www.journalofmedicaleconomics.com
Citation
British Journal Of Medical Economics, 1994, v. 7 n. 2, p. 185-196 How to Cite?
AbstractAn economic evaluation was conducted to determine the direct costs associated with managing severe gastrointestinal (GI) adverse events occurring during treatment with either Naprosyn-EC or uncoated, 'standard' naproxen. The study combined data from two double blind, randomised controlled clinical studies of six weeks duration in which the two formulations were compared. The GI adverse events included in the model were described as severe: abdominal pain, dyspepsia, nausea/vomiting, diarrhoea and constipation. The clinical studies had shown that overall there were significantly fewer GI adverse events associated with Naprosyn-EC than with standard naproxen. Detailed information regarding how general practitioners (GPs) would treat severe GI adverse events was obtained from an independent survey with a sample of 105 GPs throughout the UK. The pattern of investigation for those patients referred to hospital was obtained from three consultants. Costs were combined with these data and the adverse event incidence rates, to calculate the 'hidden costs' of treatment with standard naproxen and Naprosyn-EC, ie. the cost of treating adverse events. In this model, from a general practice perspective, the average hidden cost to the NHS of treating/investigating adverse events for each patient prescribed standard naproxen over a six-week period was £12.74 compared with £3.67 for Naprosyn-EC. Adding the drug cost of six weeks' treatment, the average total shadow costs were £19.72 and £23.84, respectively. The mean difference was £4.12, in favour of standard naproxen. Modelling the direct cost of treating these five severe GI adverse events therefore shows that Naprosyn-EC costs on average £0.69 per week more than generic standard naproxen. Extensive sensitivity analyses were conducted, including varying the GP information, using Scottish instead of English prices and allowing for future inflation. A best and worst case scenario, using the extremes of the 90% confidence interval for the adverse event rates, was also used. Substantial proportions of rile extra cost of Naprosyn-EC were saved due to its lower side effect profile. In conclusion, this economic evaluation investigated the average overall cost of treating a patient with either standard naproxen or Naprosyn-EC. The drug acquisition cost of standard naproxen is less, at generic prices, than the enteric-coated formulation. However, due to the direct costs associated with treating the greater number of severe GI side effects caused by standard naproxen, the total shadow costs for the two formulations are broadly equivalent. Indirect patient costs such as patient discomfort, loss of work or inconvenience were not included in this evaluation. The cost difference between generic, standard naproxen and Naprosyn-EC would therefore appear to be a small premium to pay since the overall well-being of the patient is the main concern.
Persistent Identifierhttp://hdl.handle.net/10722/86792
ISSN

 

DC FieldValueLanguage
dc.contributor.authorKnillJones, RPen_HK
dc.contributor.authorMcGhee, SMen_HK
dc.contributor.authorMacdonald, FCen_HK
dc.date.accessioned2010-09-06T09:21:22Z-
dc.date.available2010-09-06T09:21:22Z-
dc.date.issued1994en_HK
dc.identifier.citationBritish Journal Of Medical Economics, 1994, v. 7 n. 2, p. 185-196en_HK
dc.identifier.issn0962-1423en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86792-
dc.description.abstractAn economic evaluation was conducted to determine the direct costs associated with managing severe gastrointestinal (GI) adverse events occurring during treatment with either Naprosyn-EC or uncoated, 'standard' naproxen. The study combined data from two double blind, randomised controlled clinical studies of six weeks duration in which the two formulations were compared. The GI adverse events included in the model were described as severe: abdominal pain, dyspepsia, nausea/vomiting, diarrhoea and constipation. The clinical studies had shown that overall there were significantly fewer GI adverse events associated with Naprosyn-EC than with standard naproxen. Detailed information regarding how general practitioners (GPs) would treat severe GI adverse events was obtained from an independent survey with a sample of 105 GPs throughout the UK. The pattern of investigation for those patients referred to hospital was obtained from three consultants. Costs were combined with these data and the adverse event incidence rates, to calculate the 'hidden costs' of treatment with standard naproxen and Naprosyn-EC, ie. the cost of treating adverse events. In this model, from a general practice perspective, the average hidden cost to the NHS of treating/investigating adverse events for each patient prescribed standard naproxen over a six-week period was £12.74 compared with £3.67 for Naprosyn-EC. Adding the drug cost of six weeks' treatment, the average total shadow costs were £19.72 and £23.84, respectively. The mean difference was £4.12, in favour of standard naproxen. Modelling the direct cost of treating these five severe GI adverse events therefore shows that Naprosyn-EC costs on average £0.69 per week more than generic standard naproxen. Extensive sensitivity analyses were conducted, including varying the GP information, using Scottish instead of English prices and allowing for future inflation. A best and worst case scenario, using the extremes of the 90% confidence interval for the adverse event rates, was also used. Substantial proportions of rile extra cost of Naprosyn-EC were saved due to its lower side effect profile. In conclusion, this economic evaluation investigated the average overall cost of treating a patient with either standard naproxen or Naprosyn-EC. The drug acquisition cost of standard naproxen is less, at generic prices, than the enteric-coated formulation. However, due to the direct costs associated with treating the greater number of severe GI side effects caused by standard naproxen, the total shadow costs for the two formulations are broadly equivalent. Indirect patient costs such as patient discomfort, loss of work or inconvenience were not included in this evaluation. The cost difference between generic, standard naproxen and Naprosyn-EC would therefore appear to be a small premium to pay since the overall well-being of the patient is the main concern.en_HK
dc.languageengen_HK
dc.publisherInforma Healthcare. The Journal's web site is located at http://www.journalofmedicaleconomics.comen_HK
dc.relation.ispartofBritish Journal of Medical Economicsen_HK
dc.rightsBritish Journal of Medical Economics. Copyright © Informa Healthcare.en_HK
dc.subjectCost of treatmenten_HK
dc.subjectEconomic evaluationen_HK
dc.subjectEnteric-coated NSAIDen_HK
dc.subjectGastrointestinal side effectsen_HK
dc.subjectGeneral practiceen_HK
dc.subjectNaprosynen_HK
dc.subjectNaproxenen_HK
dc.subjectReferral ratesen_HK
dc.subjectSensitivity analysisen_HK
dc.subjectTreatment patternsen_HK
dc.titleAn economic evaluation of enteric-coated and standard formulations of naproxen from a gastrointestinal perspectiveen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0962-1423&volume=7&spage=185&epage=196&date=1994&atitle=An+economic+evaluation+of+enteric-coated+and+standard+formulations+of+naproxen+from+a+gastrointestinal+perspectiveen_HK
dc.identifier.emailMcGhee, SM:smmcghee@hkucc.hku.hken_HK
dc.identifier.authorityMcGhee, SM=rp00393en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.scopuseid_2-s2.0-0028609866en_HK
dc.identifier.hkuros1118en_HK
dc.identifier.volume7en_HK
dc.identifier.issue2en_HK
dc.identifier.spage185en_HK
dc.identifier.epage196en_HK
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridKnillJones, RP=7005683096en_HK
dc.identifier.scopusauthoridMcGhee, SM=7003288588en_HK
dc.identifier.scopusauthoridMacdonald, FC=7005735286en_HK

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats