COST EFFECTIVENESS OF REPLACING DICLOFENAC WITH A FIXEDCOMBINATION OF MISOPROSTOL AND DICLOFENAC IN PATIENTWITH RHEUMATOID ARTHRITISS固定雙氯芬酸的成本-效果 米索前列醇與雙氯芬酸的聯(lián)合應(yīng)用 類風(fēng)濕性關(guān)節(jié)炎

COST EFFECTIVENESS OF REPLACING DICLOFENAC WITH A FIXEDCOMBINATION OF MISOPROSTOL AND DICLOFENAC IN PATIENTWITH RHEUMATOID ARTHRITISS固定雙氯芬酸的成本-效果 米索前列醇與雙氯芬酸的聯(lián)合應(yīng)用 類風(fēng)濕性關(guān)節(jié)炎

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COST EFFECTIVENESS OF REPLACING DICLOFENAC WITH A FIXEDCOMBINATION OF MISOPROSTOL AND DICLOFENAC IN PATIENTWITH RHEUMATOID ARTHRITISS固定雙氯芬酸的成本-效果 米索前列醇與雙氯芬酸的聯(lián)合應(yīng)用 類風(fēng)濕性關(guān)節(jié)炎_第1頁
COST EFFECTIVENESS OF REPLACING DICLOFENAC WITH A FIXEDCOMBINATION OF MISOPROSTOL AND DICLOFENAC IN PATIENTWITH RHEUMATOID ARTHRITISS固定雙氯芬酸的成本-效果 米索前列醇與雙氯芬酸的聯(lián)合應(yīng)用 類風(fēng)濕性關(guān)節(jié)炎_第2頁
COST EFFECTIVENESS OF REPLACING DICLOFENAC WITH A FIXEDCOMBINATION OF MISOPROSTOL AND DICLOFENAC IN PATIENTWITH RHEUMATOID ARTHRITISS固定雙氯芬酸的成本-效果 米索前列醇與雙氯芬酸的聯(lián)合應(yīng)用 類風(fēng)濕性關(guān)節(jié)炎_第3頁
COST EFFECTIVENESS OF REPLACING DICLOFENAC WITH A FIXEDCOMBINATION OF MISOPROSTOL AND DICLOFENAC IN PATIENTWITH RHEUMATOID ARTHRITISS固定雙氯芬酸的成本-效果 米索前列醇與雙氯芬酸的聯(lián)合應(yīng)用 類風(fēng)濕性關(guān)節(jié)炎_第4頁
COST EFFECTIVENESS OF REPLACING DICLOFENAC WITH A FIXEDCOMBINATION OF MISOPROSTOL AND DICLOFENAC IN PATIENTWITH RHEUMATOID ARTHRITISS固定雙氯芬酸的成本-效果 米索前列醇與雙氯芬酸的聯(lián)合應(yīng)用 類風(fēng)濕性關(guān)節(jié)炎_第5頁
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1、ARTHRITIS&RHEUMATISMVol.42,No.11,November1999,pp2293±2302?1999,AmericanCollegeofRheumatology2293COSTEFFECTIVENESSOFREPLACINGDICLOFENACWITHAFIXEDCOMBINATIONOFMISOPROSTOLANDDICLOFENACINPATIENTSWITHRHEUMATOIDARTHRITISIVARSéNBéKRISTIANSEN,TOREKRISTIANKVIEN,andERIKNORDObjective.Toestimatethecostsand

2、healthcon-Nonsteroidalantiinflammatorydrugs(NSAIDs)sequencesofreplacingtreatmentwithdiclofenac50mgareinwidespreaduse,butcancausepepticulcersandwithafixedcombinationofdiclofenac50mgandgastrointestinal(GI)bleedingandperforation(1±3).misoprostol0.2mg3timesadayinpatientswithTheriskofsuchcomplicatio

3、nsinrheumatoidarthritisrheumatoidarthritis(RA).(RA)patientstakingNSAIDsmaybe6timesthatinRAMethods.Adecisiontreewasdevelopedtosimu-patientsnottakingNSAIDs(4).AccordingtoFries,thelate6monthsofnonsteroidalantiinflammatorydrugannualriskofdeathorhospitalizationduetoupperGI(NSAID)treatmentforRA.Thepr

4、obabilitiesofthediseaseis1.3±1.6%inRApatientstakingNSAIDs,whileclinicaloutcomeswerebasedonaliteraturereview.Atheratemaybeashighas4±5%incertainhigh-risksurveyofNorwegianrheumatologistswasundertakentogroups(5).exploretheirclinicalmanagementofdyspepsiainRAMisoprostolisasyntheticprostaglandinanalog

5、patientstakingNSAIDs.ValuationofhealthstateswasthatwhentakenalongwithNSAIDs,isshowntobasedonresultsoftheShortForm36healthsurvey.reducetheoccurrenceofendoscopicallyprovengas-Results.InfemaleRApatientswithoutanyrisktricandduodenalulcers(6±11).However,theuseoffactorsassociatedwithseriousgastrointe

6、stinal(GI)misoprostolisitselfassociatedwithminorGIsymp-complications,theincrementalcostofreplacingdiclo-toms,foremostofwhicharediarrheaandabdominalfenacwiththefixedmisoprostol/diclofenaccombinationpain(6±10,12±14).Thissomewhatlimitstheuseful-therapywas$72,700perquality-adjustedlife-yearnessofth

7、isdrug.Additionalcosts,whichshouldtobegained.Forpatientswith1riskfactor,thecostwaslessjustifiedbyitsnethealthbenefits,arealsoincurred.than$16,000.With2or3riskfactors,theuseofThemanyeconomicanalysesaddressingthisissuemisoprostolwas

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