Meeting / Value in Health Info: ISPOR 12th Annual European Congress
Paris, France
October, 2009
Code: PMS47
Disease: Arthritis, Osteoarthritis
Topic: Cost Studies
Topic Subcategory: Cost-Effectiveness Analysis (CE)
Title: POTENTIAL HEALTH ECONOMIC BENEFITS OF IMPROVING THE CARDIOVASCULAR SAFETY PROFILE OF NSAIDS
Author(s):
Svedbom
A1, Pfister P2, Miltenburger C3, Holmstrom S2, Borgstrom F11i3 Innovus,
Stockholm, Sweden, 2NicOx, Sophia Antipolis Cedex, France, 3i3 Innovus,
Berlin, Germany
Content:
OBJECTIVES:
To quantify potential cost savings and quality adjusted life year
(QALY) gains of improving the blood pressure (BP) profile of
non-steroidal anti inflammatory drugs (NSAIDs). METHODS: Increasing
attention has been paid to the cardiovascular (CV) risk of NSAIDs,
partially triggered by the withdrawal of rofecoxib. Small increases in
BP associated with NSAID use contribute to the CV toxicity of NSAIDs.
OA patients often have an elevated risk for CV events due to
characteristics common to this population; advanced age, obesity, and
co-morbidities such as diabetes, hypertension and other CV risks. In
order to quantify the potential health economic benefits of improvement
in the BP profile of NSAIDs, an individual state transition model (one
year cycles, 5-year treatment duration, life-time model horizon,
healthcare perspective) encompassing eight CV events (congestive heart
failure, stroke, transient ischemic attack, myocardial infarction,
stable angina, unstable angina, stroke death and MI death) caused or
exacerbated by increases in BP was constructed. The model was populated
with UK data. The model was used to estimate potential cost savings and
QALY benefits from avoided cardiovascular events associated with four
levels of relative risk reductions (RRRs) with a hypothetical NSAID
(5%, 10%, 15%. 20% and 25%) compared to naproxen – widely regarded the
NSAID with the most benign CV profile currently on the market – at
three levels of absolute 10-year primary CV risk (20%, 30% and 40%).
RESULTS: As expected the cost savings and QALY benefits associated with
avoided cardiovascular events increased with the level of RRR and
10-year absolute CV risk. Potential cost savings ranged from GBP 181 to
GBP 1,591, whereas the QALY benefits ranged from 0.05 to 0.44.
CONCLUSIONS: An NSAID with an improved BP profile has the potential to
provide significant health economic benefits, especially in patients
with elevated CV risk.