Drugs & Aging

, Volume 8, Issue 2, pp 84–88 | Cite as

Use of Misoprostol in the Elderly

Is the Expense Justified?
  • Gerold Stucki
  • Magnus Johannesson
  • Matthew H. Liang
Leading Article


Misoprostol is a prostaglandin E1 analogue which reduces both gastric ulcerations and clinically important bleeding in patients taking nonsteroidal anti-inflammatory drugs (NSAIDs). Economic evaluations of prophylactic use of misoprostol with NSAIDs differ in their conclusions mainly because of different assumptions regarding the absolute risk reduction of symptomatic ulcers. Assuming a conservative estimate of the absolute risk reduction based on new effectiveness data, all studies would have concluded that misoprostol prophylaxis results in net costs in the general population of NSAID users. However, in the elderly with a clearly increased risk of gastrointestinal (GI) lesions and ulcer complications, and an increased hospitalisation rate, misoprostol may be cost saving. Also, in the elderly the gain in quality of life seems to offset the uncertain reduction in quality of life due to the adverse effects of misoprostol. However, the suggestion that misoprostol prophylaxis in the elderly is cost effective or cost saving needs to be confirmed in further studies.


Economic Evaluation Gastric Ulcer Piroxicam Misoprostol Absolute Risk Reduction 
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Copyright information

© Adis International Limited 1996

Authors and Affiliations

  • Gerold Stucki
    • 1
    • 3
  • Magnus Johannesson
    • 2
  • Matthew H. Liang
    • 3
  1. 1.Department of Rheumatology and Physical MedicineUniversity Hospital ZurichZürichSwitzerland
  2. 2.Centre for Health EconomicsStockholm School of EconomicsStockholmSweden
  3. 3.Departments of Medicine and Rheumatology/Immunology, and Robert B. Brigham Multipurpose Arthritis and Musculoskeletal Disease CenterBrigham and Women’s HospitalBostonUSA

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