Study Findings Question COX-2 Drug Cost Effectiveness

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Study Findings Question COX-2 Drug Cost Effectiveness

http://www.newswise.com/articles/view/502322/?sc=wire

Findings reported in a study published today by The American Journal of

Managed Care call into question the cost effectiveness of the new, more

expensive COX-2 anti-inflammatory drugs. Using data representing actual

clinical practice, researchers sought to validate the rate of

co-prescribing of agents used to protect the gastrointestinal tract -- a

key assumption made in prior COX-2 cost-effectiveness studies.

COX-2 drugs offer greater protection from adverse gastrointestinal

events than lower-cost, traditional nonsteroidal anti-inflammatory

drugs, although both types are equally effective in treating pain.

As a result, estimates of COX-2 cost effectiveness assumed – based on

expert opinion – that most physicians prescribing COX-2 drugs would

either stop or dramatically reduce their prescribing of a second drug to

protect the gastrointestinal system, which occurs approximately 25% of

the time when traditional NSAIDs are prescribed.

However, researchers at pharmacy benefit manager Express Scripts

discovered many COX-2 prescribing physicians actually continued

co-prescribing gastroprotective drugs like proton pump inhibitors or H2

receptor antagonists. In fact, the study found that gastroprotective

drug use was actually higher for COX-2 patients than for those taking a

traditional NSAID – by a margin of 20% vs. 18%.

“These findings call into question the use of expert opinion in

estimating practice pattern model inputs prior to a product’s use in

clinical practice, warranting a re-evaluation of COX-2 cost

effectiveness models,” said lead author , PhD, of Express

Scripts. She and her team had examined medical and pharmacy claims data

at a Midwestern preferred provider organization.

“The harm from incorrect assumptions, such as those found in the

cost-effectiveness evaluations of COX-2s, is that they undermine the

efficient allocation of scarce healthcare resources,” added .

This is the second study recently published by Express Scripts

researchers on the validity of cost effectiveness evaluations of new

drugs. In a September Journal of Managed Care Pharmacy article they

reported that economic models used to compare ulcer treatments

overstated the cost-effectiveness of more expensive treatments. They

looked at treatments that combined antibiotics with either a generic

bismuth drug or a more expensive branded proton pump inhibitor (PPI).

The more economical bismuth-based treatment was actually the most

cost-effective.

In other research on COX-2 drugs, in November The American Journal of

Managed Care published another Express Scripts study, which found that

most patients given new prescriptions for the drugs had no indication of

being at risk for gastrointestinal events.