Cost of treating arthritis and NSAID-related gastrointestinal side-effects.

Non-steroidal anti-inflammatory drugs (NSAIDs) are efficacious in the treatment of arthritis. However, side-effects particularly gastrointestinal toxicity, have been well documented with their use. Thus, in assessing total direct medical costs in the treatment of arthritis, the expenses involved in treating these side-effects must be taken into account. A retrospective analysis was undertaken of all direct medical costs related to care of a group of Medicaid recipients treated for arthritis during a 2-year period. Data were obtained from the Medicaid Management Information System of Washington, D.C., USA. The actual expenditure of treating arthritis as well as the medical costs of associated NSAID-induced gastrointestinal side-effects were determined. Arthritis treatment costs per quarter were found to be $145 per patient. Approximately 25% of the population experienced NSAID-related gastrointestinal side-effects requiring further medical care. Treatment of these adverse effects costs an additional $66 per quarter per patient, thus adding 45.5% to the cost of arthritis treatment. Pharmaceutical claims comprised 42.4% of total adverse drug reaction treatment costs, while the few hospital claims accounted for 37.9% and physician charges 19.7%. It has been estimated that in 1983 direct medical costs of arthritis treatment in the USA was $8.6 billion. By extrapolating the costs in this study, it can be estimated that a further $3.9 billion was spent on treating gastrointestinal side-effects of NSAIDs, making a total of $12.5 billion.