RESEARCH - The cost of steroid-associated adverse events in RA

April 20, 2005

Rheumatology (Oxford). 2005 Mar 15; [Epub ahead of print]

The cost of glucocorticoid-associated adverse events in rheumatoid

arthritis.

Pisu M, N, Sampsel S, Saag KG.

Center for Outcomes and Effectiveness Research and Education (COERE),

University of Alabama at Birmingham, USA.

Objective. To estimate the costs of glucocorticoid associated adverse events

(GAEs) in patients with rheumatoid arthritis (RA). Methods. We conducted a

literature review of studies reporting GAEs in RA patients, and developed a

Markov model with the following GAEs: fractures (vertebral, hip, pelvic),

hypertension, diabetes, gastrointestinal complications, pneumonia, urinary

tract infection, cataract and, in an extended model, myocardial infarction

(MI) and stroke. Two-year total costs were calculated using direct medical

costs (2001 US dollars) and by running 10,000 Monte Carlo simulations with

probability values randomly selected from the GAE literature. Results. On

average, glucocorticoid users spent \$445 more than non-users, or \$0.46 for

each dollar spent on purchasing the drug. When adding MI and stroke, users

spent on average \$430 more than non-users, or \$0.44 for each dollar spent

on purchasing the drug; this incremental cost ranged from \$193 to \$682 if

MI and stroke were excluded, respectively. In 70% of the simulations there

were more deaths among users than among non-users, in both the model with

and without MI and stroke.

Conclusions. Although results varied depending on attributed GAEs, in

general glucocorticoid users spent more than non-users on GAE treatment, and

had higher mortality. Patients, providers and policy makers should consider

these potential costs of GAEs when making treatment decisions.

PMID: 15769791

ct & list_uids=15769791 & itool=iconabstr

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

s Hopkins Medicine

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