Epidemiological and financial aspects of the use of non-steroidal anti-inflammatory analgesics.

The availability of many new nonsteroidal anti-inflammatory drugs (NSAIDs) has increased the total consumption during the past 20 years. The cost of different NSAID brands varies considerably probably reflecting increased research and development costs rather than a true therapeutic benefit for the patient. The current therapeutic problem in the treatment of musculoskeletal conditions with NSAIDs is to make a balanced analysis between benefits, risks, and costs. Assessment of risks and benefits should focus on the large subgroup (about 40%) of elderly NSAID users over 60 years who clearly stand at increased risk of NSAID-induced gastrointestinal complications. In the treatment of osteoarthritis more trials are needed to compare NSAIDs with plain analgesics (e.g. paracetamol).