BresMed Health Solutions, Sheffield, UK.
J Med Econ. 2012;15(3):465-72. doi: 10.3111/13696998.2012.659778. Epub 2012 Feb 14.
The National Institute for Health and Clinical Excellence (NICE) health economic model for assessing the cost-effectiveness of celecoxib plus a proton pump inhibitor (PPI) compared to diclofenac plus PPI in the treatment of osteoarthritis has been updated using new adverse event (AE) risks from the CONDOR trial. In light of this new information, this study aimed to evaluate the incremental cost-effectiveness ratio (ICER) of celecoxib plus PPI compared to diclofenac plus PPI.
NICE developed a health economic model as part of their 2008 multiple technology assessment of treatments for osteoarthritis. The model was adapted for this study to update the relative risks of adverse events, using data from the CONDOR trial.
Using the AE data from the CLASS trial alone, celecoxib plus PPI has an ICER of £9538 per QALY when compared to diclofenac plus PPI. When the AE data from CONDOR alone is used, this ICER decreases to £4773 per QALY. Using the pooled data from both trials, celecoxib plus PPI has an ICER of £9377 per QALY compared to diclofenac plus PPI.
The results suggest that when new AE risks are used, celecoxib plus PPI remains a cost-effective treatment for OA when compared to diclofenac plus PPI. However, this analysis is limited by the short time horizon, and additional AEs that have not been considered.
英国国家卫生与临床优化研究所（NICE）用于评估塞来昔布联合质子泵抑制剂（PPI）与双氯芬酸联合 PPI 治疗骨关节炎的成本效益的健康经济模型已使用 CONDOR 试验的新不良事件（AE）风险进行了更新。鉴于此新信息，本研究旨在评估塞来昔布联合 PPI 与双氯芬酸联合 PPI 的增量成本效益比（ICER）。
NICE 作为其 2008 年治疗骨关节炎多种技术评估的一部分，开发了一种健康经济模型。本研究对模型进行了调整，以使用 CONDOR 试验的数据更新不良事件的相对风险。
仅使用 CLASS 试验的 AE 数据，塞来昔布联合 PPI 与双氯芬酸联合 PPI 相比，每 QALY 的 ICER 为 9538 英镑。仅使用 CONDOR 的 AE 数据时，该 ICER 降至每 QALY 4773 英镑。使用两项试验的汇总数据，与双氯芬酸联合 PPI 相比，塞来昔布联合 PPI 的每 QALY 的 ICER 为 9377 英镑。
结果表明，当使用新的 AE 风险时，与双氯芬酸联合 PPI 相比，塞来昔布联合 PPI 仍然是治疗 OA 的一种具有成本效益的治疗方法。但是，该分析受到短期时间范围和未考虑的其他 AE 的限制。
