Henryetta Barry
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The cost-effectiveness of acetaminophen, NSAIDs, and selective COX-2 inhibitors in the best pain relievers treatment of symptomatic knee osteoarthritis.OBJECTIVE. Separate pain relievers analyses were conducted for all patients and for those who did not respond to acetaminophen. In terms pain relievers of pain relief, cost-effectiveness male female chemistry acceptability curves indicate that if one values pain relief below 275 US dollars per patient achieving MPCI, acetaminophen is pain pills the therapy most likely to be optimal; between 275 US dollars and chemistry reference table 2002 14,150 US dollars, ibuprofen is most likely to be optimal; and above 14,150 US dollars, rofecoxib natural pain relief is most likely to be optimal.. Costs were derived from actual resource utilization of OA patients. 1) number of upper gastrointestinal (GI) adverse events averted; and 2) number of patients who achieved perceptible pain relief. Outcome probabilities were obtained from a comprehensive review of randomized pain management controlled trials and observational studies. In terms of pain control, ibuprofen had an ICER of 610.77 US dollars per additional patient achieving minimal perceptible clinical pain killers improvement (MPCI) relative to acetaminophen, while rofecoxib had an ICER of 12,000 US dollars relative to ibuprofen. Our results suggest that for average-risk knee OA patients, acetaminophen dominates the other therapies in terms of cost per GI event averted. A decision analysis model was designed over 6 months using two measures of effectiveness. One-way, two-way, and probabilistic sensitivity analyses established that these results were generally robust. In terms of averting GI events, acetaminophen dominates the other options for an average risk patient population. The objective of this study was to conduct an economic evaluation of rofecoxib and celecoxib compared with high-dose acetaminophen or ibuprofen with and without misoprostol for patients with symptomatic knee osteoarthritis (OA). For patients who did not respond to acetaminophen and who are at high risk of developing an adverse GI event, rofecoxib dominates ibuprofen as the preferred alternative for both measures of effectiveness. For patients who did not respond to acetaminophen, rofecoxib had the lowest incremental cost-effectiveness ratio (ICER) per GI event avoided (32,000 US dollars) relative to ibuprofen.
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