University of Illinois at Chicago, Department of Pharmacy Administration, Chicago, IL 60612, USA.
Curr Med Res Opin. 2010 Sep;26(9):2253-61. doi: 10.1185/03007995.2010.505545.
Flavocoxid is a medical food used for the clinical dietary management of osteoarthritis (OA). The acquisition cost of flavocoxid is higher than most traditional, generic NSAIDs. However, flavocoxid may have more favorable gastrointestinal (GI) toxicity resulting in lower overall costs. These costs have not been previously examined. This study provides a decision analytic model to assess the net costs of using flavocoxid for OA from a Medicare perspective.
A decision model was developed to estimate the total costs associated with flavocoxid versus naproxen for the management of Medicare patients with mild to moderate OA. Probabilities were obtained from literature and expert opinion, and costs were obtained from Medicare. Sensitivity analyses were conducted by varying probabilities and costs within clinically relevant ranges.
The base case resulted in flavocoxid having lower total annual costs ($1482 per patient) compared to naproxen ($1592). Flavocoxid remained the lowest cost option when the cost inputs were varied by 25% (above and below the base case), and when the probability of GI events with flavocoxid were varied by 25%. However, when GI rates from the literature and implied relative risks from the expert panel were used, or if the cost of PPIs was $0, then naproxen was the less costly alternative, though saving less than the annual cost of flavocoxid. Key limitations were the limited outcomes in the model (only GI events), lack of consideration of adherence or combination therapy, and the reliance on expert opinion due to a lack of data for flavocoxid.
In patients over 65 years of age who suffer from mild to moderate OA, flavocoxid may result in lower overall costs, despite a higher acquisition cost. Managed care organizations should consider total health care costs in the decision to include flavocoxid as a covered benefit.
Flavocoxid 是一种用于治疗骨关节炎（OA）的临床饮食管理的医用食品。Flavocoxid 的采购成本高于大多数传统的、通用的 NSAIDs。然而，Flavocoxid 可能具有更有利的胃肠道（GI）毒性，从而导致总体成本降低。这些成本以前没有被审查过。本研究提供了一个决策分析模型，从医疗保险的角度评估使用 Flavocoxid 治疗 OA 的净成本。
开发了一个决策模型，以评估 Flavocoxid 与萘普生治疗医疗保险患者轻度至中度 OA 的相关总成本。概率来自文献和专家意见，成本来自医疗保险。通过在临床相关范围内变化概率和成本进行了敏感性分析。
基础案例导致 Flavocoxid 的总年度成本（每位患者 1482 美元）低于萘普生（1592 美元）。当成本输入变化 25%（高于和低于基础案例）时，当 Flavocoxid 的 GI 事件概率变化 25%时，Flavocoxid 仍然是成本最低的选择。然而，当使用文献中的 GI 率和专家小组暗示的相对风险，或者如果 PPI 的成本为 0 时，那么萘普生是成本较低的选择，尽管节省的费用少于 Flavocoxid 的年度成本。主要限制因素是模型中有限的结果（仅 GI 事件）、缺乏对依从性或联合治疗的考虑，以及由于缺乏 Flavocoxid 的数据而依赖专家意见。
在 65 岁以上患有轻度至中度 OA 的患者中，尽管采购成本较高，但 Flavocoxid 可能会导致总体成本降低。管理式医疗组织在决定将 Flavocoxid 作为涵盖福利时，应考虑总医疗保健成本。
