Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-28T17:56:30.506Z Has data issue: false hasContentIssue false
  • English
  • Français

Cost-effectiveness of Misoprostol in Sweden

Published online by Cambridge University Press:  14 October 2009

Bengt Jönsson  and
Ulf Haglund
Bengt Jönsson
Affiliation:
Stockholm School of Economics
Ulf Haglund
Affiliation:
Akademiska Hospital, Uppsala University
Get access Rights & Permissions [Opens in a new window]

Abstract

Based on an American multicenter study, an economic evaluation of prophylactic misoprostol was undertaken in Sweden. The study included 420 patients with osteoarthritis and nonsteroidal anti-inflammatory drug (NSAID)-associated abdominal pain, but no gastric ulcer at inclusion. The frequency of ulcer development with and without prophylactic misoprostol was assessed at 21.7% and 5.6%, respectively, for a 3-month period. All costs for drugs, ambulatory care, hospital care, loss of production, as well as other factors such as dosage and compliance, were transferred to Swedish conditions. It was concluded that in patients with osteoarthritis and NSAID-induced abdominal pain, prophylaxis with misoprostol is cost-effective in Sweden, which is similar to what is found for other countries. A prerequisite for this result is a frequency of ulcer development of 15%. A patient compliance to prophylactic treatment of more than 60% is also presupposed (79% was observed in the above study). Due to the high age of the osteoarthritis patient population, the cost-effectiveness is influenced to only a minor extent by whether indirect costs are included in the calculation.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 8 , Issue 2 , Spring 1992 , pp. 234 - 244
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Bloom, B. S. The medical, social, and economic implications of disease. In van Eimeren, W. & Horisberger, B. (eds.), Socioeconomic evaluation of drug therapy. Berlin: Springer-Verlag, 1988.Google Scholar
2.Brodin, H., Hedenbro, J., & Liedberg, G.Ulcer surgery made less expensive. Annals of Surgery, 1983, 198, 5–8.Google Scholar
3.Carlsson, P. Spridning och ekonomiska effekter av medicinsk teknologi-vid behandling av magsår, prostataförstoring och gallsten. Linköping Studies in Arts and Science No. 12. Dissertation. Linköping, Sweden: Linköping University, 1987.Google Scholar
4.Carrin, G. J., & Torfs, K. E.Economic evaluation of prophylactic treatment with misoprostol in osteoarthritic patients treated with NSAIDs. The case of Belgium. Revue d'Epidemi-ologie et de Santé Publique, 1990, 38, 187–99.Google ScholarPubMed
5.de Pouvourville, G.Use of misoprostol as a prophylactic treatment in gastric ulceration associated with nonsteroid anti-inflammatory drugs: An economic evaluation in the French context. Paris: Centre de Reserche en Gestion, Ecole Polytechnique, 1990 (mimeo, June 1989).Google Scholar
6.Gastroskopi-vid utredning av ont i magen. Statens beredning för utvärdering av medicinsk teknologi. Stockholm: 1990.Google Scholar
7.Graham, D. Y., Agrawal, N. W., & Roth, S. H.Prevention of NSAID-induced gastric ulcer with misoprostol: Multicentre, double-blind placebo-controlled trial. Lancet, 1988, ii, 1277–80.CrossRefGoogle Scholar
8.Grosse, P. F., & Glasziou, XX. An Australian economic analysis of the prevention of NSAID-induced gastric ulceration by misoprostol. Sydney: Health Economics and Technology Corporation Pty. Ltd., 1990.Google Scholar
9.Gustavsson, S., & Nyren, O.Stadig minskning av operationer för ventrikel-och duodenalsår. Läkartidningen, 1989, 40, 3357–61.Google Scholar
10.Hillman, A. L., & Bloom, B. S.Economic effects of prophylactic use of misoprostol to prevent gastric ulcer in patients taking nonsteroidal anti-inflammatory drugs. Archives of Internal Medicine, 1989, 149, 2061–65.Google Scholar
11.Jacobs, J., & Bloom, B. S.Compliance and costs in NSAID therapy. Hosp. Ther., 1987, (suppl.), 32–39.Google Scholar
12.Jönsson, B. The value of prevention: Economic aspects. In CIBA Foundation (ed.), The value of preventive medicine. London: Pitman, 1985, 22–33.Google Scholar
13.Knill-Jones, R., Drummond, M., Harpreet, K., & Davis, L.Economic evaluation of gastric ulcer prophylaxis in patients with arthritis receiving nonsteroidal anti-inflammatory drugs. Postgraduate Medical Journal, 1990, 66, 639–46.CrossRefGoogle Scholar
14. Kostnader per intagen patient, vårddag, läkarbesök mm 188. Stockholm: Landstingsför-bundet, 1990.Google Scholar
15. Medical Index Sweden, Läkemedelsstatistik, 1988.Google Scholar
16.Office of Technology Assessment, U.S. Congress. Background paper no. 2: Case studies of medical technologies. Case study no. 8: The cost-effectiveness of upper gastrointestinal endoscopy. In The implications of cost-effectiveness analysis of medical technology. Washington, DC: U.S. Government Printing Office, 1980 (GPO stock no. 052™003™00765™7).Google Scholar
17.Riksförsäkringsverket informerar. Den ersatta sjukfrånvarons diagnoser 1983. Stockholm: 1987 (statistisk rapport Is-R 1987:5).Google Scholar
18.SPRI. DRG i Sverige-Anpassning och registerstudir. Stockholm: SPRI, 1990 (SPRI rapport 281).Google Scholar
19. Ström, M.Comparison between medical and elective surgical treatment of peptic ulcers. Scandinavian Journal of Gastroenterology, 1988, 155(suppl.), 159–65.Google Scholar
20.Walan, A., Bader, J.-P., Classen, M., et al. The effects of omeprozol and ranitidine on ulcer healing and relapse rates in patients with benign gastric ulcer. New England Journal of Medicine, 1989, 320, 69–75.CrossRefGoogle ScholarPubMed