Economic Evaluation of Nimesulide versus Diclofenac in the Treatment of Osteoarthritis in France, Italy and Spain
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To assess and compare the incremental costs of the 15-day treatment of osteoarthritis (OA) with nimesulide vs that with diclofenac in France, Italy and Spain.
A cost-minimisation analysis was performed through a decision tree, assuming the National Health System perspective. A meta-analysis was performed to assess the incidence of gastrointestinal adverse events (GIAEs) in patients with OA treated with nimesulide or diclofenac.
Three studies were included in the meta-analysis, which included a sample size of 484 patients in total. The incidence of GIAEs is higher in patients treated with diclofenac than in those treated with nimesulide. Nimesulide is cost-saving in all three countries: treatment costs are reduced by Euro dollars (EUR) 1.5 per case in France, EUR2 in Italy and EUR3.6 in Spain. Final results are not sensitive to variation of incidence rates of gastric and intestinal events and to changes in the resource consumption: nimesulide always remains cost-saving.
This is the first economic analysis carried out in three different countries on original epidemiological data comparing nimesulide and diclofenac directly. Projecting our results to the estimated OA prevalence in the entire population of the three countries, the expected savings to the NHS would vary from a minimum of EUR17 500 000 in France to a maximum of EUR30 000 000 in Spain. It can be stated that these findings can provide support for clinicians and policy-makers for the adoption of this cost-saving treatment strategy in patients with OA.
KeywordsNational Health Service Nimesulide Resource Consumption Direct Healthcare Cost Gastric Erosion
This work would not have been possible without the contribution of the General Practitioners in France, Italy and Spain, whom we wish to thank.
This research was supported by a financial contribution from Helsinn Healthcare SA, Lugano, Switzerland.
- 2.Kadar D. Anti-inflammatory analgesics. In: Kalant H, Roschlau WHE, editors. Principles of medical pharmacology, 5th edition. Toronto: BC Decker, 1989: 325–37Google Scholar
- 3.Tabacchi M, Tarricone R. Un’analisi di convenienza economica comparata: il trattamento dell’osteoartrosi e dell’artrite reumatoide con Farmaci Antiinfiammatori Non-Steroidei. MECOSAN 1998; 25: 53–62Google Scholar
- 11.IMS Health, 1999Google Scholar
- 15.Gui Xin Q, Jin J, Jian Xiong S, et al. The efficacy and tolerability of nimesulide vs. diclofenac sodium in the treatment of osteoarthritis of the knee 1997 (data on file, Helsinn Healthcare SA, Lugano, Switzerland)Google Scholar
- 17.UCANSS. Nomenclature générale des actes professionnels. Paris 2000Google Scholar
- 18.Conselleria de Sanitat (Catalunya). Entidades de seguro de asistencia sanitaria en Cataluña 1999Google Scholar
- 19.OEMF. L’Informatore Farmaceutico. Milano 1999Google Scholar
- 20.Catalogo de especialidades farmaceuticas. Consejo general de Colegios Oficiales Farmaceuticos 1999Google Scholar
- 21.Dictionnaire VIDAL 2000, Editions du Vidal, ParisGoogle Scholar
- 23.Rennie D, Flanagin A. Publication bias. The triumph of hope over experience. Curr Ther Res 1992; 267: 411Google Scholar