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Study Finds Hidden Costs with Non-steroidal Anti-inflammatory Drugs

  [ 85 votes ]   [ Discuss This Article ] • April 16, 2003

Nonselective, non-steroidal anti-inflammatory drugs (NSAIDs) used to treat the pain associated with arthritis, are well known to increase the risk for certain side effects such as stomach upset, high blood pressure, and cardiovascular disease. New research published in the April 2003 issue of The Journal of Rheumatology examined the excess risk and costs associated with the major adverse effects of prescription NSAIDs and found the excess cost is modest in low risk patients, but much higher in patients with specific risk factors.

Researchers from Brigham and Women's Hospital, Harvard Medical School examined a random group of 41,826 patients over 65 years of age continuously enrolled in the New Jersey Pharmaceutical Assistance to the Aged and Disabled or Medicaid programs. The researchers calculated the adjusted rates and costs of major adverse effects associated with nonselective NSAIDs, including hospitalization for GI hemorrhage, use of stomach protective drugs.

Results showed that 18 percent of patients filled at least one new prescription for an NSAID during the study period. Of these all adverse effects studied were more common in patients filling prescriptions for NSAIDs than in those who did not. They also found that the average annual cost for the adverse effects caused by NSAIDS were $1,234 compared to $1,036 in controls. After adjusting for sociodemographic factors, other health care utilization, and relevant diseases, the average annual cost for the adverse events caused by NSAIDS was $117 higher for patients filling a prescription than those who did not. NSAID users with four or more risk factors for related adverse effects had and average excess costs of $316 over controls, whereas those with no risk f actors had an average excess cost of only $75.

The excess cost of NSAID related adverse effects is relatively modest for low risk patients, however is much higher in those with the specific risk factors. The researchers believe approaching patients based on their risk for NSAID effects can help clinicians determine those who might be appropriate candidates for alternative treatment options.

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