Análisis coste-efectividad del empleo de celecoxib en el tratamiento de la artrosis
Cost-effectiveness analysis of the use of celecoxib for the treatment of osteoarthritis
A. Morenoa, E. Vargasa, J. Sotob,
, J. Rejasc
Autor para correspondencia
javier.soto.alvarez@pharmacia.com
Correspondencia: Dr. Javier Soto Álvarez. Pharmacia, SA. Avda. de Burgos 17-1.a planta. 28036 Madrid. España.
Correspondencia: Dr. Javier Soto Álvarez. Pharmacia, SA. Avda. de Burgos 17-1.a planta. 28036 Madrid. España.
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"apellidos" => "Vargas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:4 [ "nombre" => "J." "apellidos" => "Soto" "email" => array:1 [ 0 => "javier.soto.alvarez@pharmacia.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Rejas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Farmacología Clínica. Hospital Clínico San Carlos. Madrid. España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Farmacoeconomía e Investigación de Resultados en Salud. Departamento de Medicina. Pharmacia, SA. Madrid. España" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Investigación de Resultados en Salud. Departamento Médico. Pfizer, SA" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "<span class="elsevierStyleItalic">Correspondencia:</span> Dr. Javier Soto Álvarez. Pharmacia, SA. Avda. de Burgos 17-1.<span class="elsevierStyleSup">a</span> planta. 28036 Madrid. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cost-effectiveness analysis of the use of celecoxib for the treatment of osteoarthritis" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-05-02" "fechaAceptado" => "2002-11-05" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec268794" "palabras" => array:5 [ 0 => "Artrosis" 1 => "Celecoxib" 2 => "AINE convencionales" 3 => "Análisis coste-efectividad" 4 => "Eficiencia" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec268793" "palabras" => array:5 [ 0 => "Osteoarthritis" 1 => "Celecoxib" 2 => "Traditional NSAIDs" 3 => "Cost effectiveness analysis" 4 => "Efficiency" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Antecedentes</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los antiinflamatorios no esteroideos (AINE), utilizados en el tratamiento de la artrosis, pueden producir reacciones adversas gastrointestinales (GI) graves.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Celecoxib, un inhibidor específico de la ciclooxigenasa 2 (COX-2), ha demostrado una eficacia equivalente a los AINE convencionales con un mejor perfil de tolerabilidad y seguridad.</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La finalidad de este estudio ha sido realizar un análisis coste-efectividad sobre el uso de celecoxib frente a los AINE clásicos en el tratamiento de la artrosis.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El análisis coste-efectividad se ha diseñado mediante un modelo farmacoeconómico, definiéndose como unidad de efectividad a cada año de vida ganado tras la toma de celecoxib o AINE. La probabilidad de que aparezcan los diferentes resultados clínicos se ha obtenido de artículos publicados y de asunciones incorporadas.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Sólo se han valorado los costes directos médicos (medicación, hospitalización, pruebas complementarias, analíticas, visitas extras, etc.), sin haberse incluido otros costes.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La perspectiva del estudio ha sido la del Sistema Nacional de Salud y el horizonte temporal elegido ha sido de 6 meses.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El coste adicional por cada año de vida ganado secundario al uso de celecoxib frente a los AINE clásicos asciende a 8.017 € (1.333.834 ptas.). El análisis de sensibilidad muestra cómo estos valores son sensibles a la modificación del coste de AINE y gastroprotector, así como a la inclusión de grupos poblacionales con edades más bajas.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Celecoxib puede ser considerado como una opción coste-efectiva en el tratamiento de la artrosis, ya que va a evitar muertes y a ganar años de vida para los pacientes con un coste adicional razonable y moderado, cuando se compara con los AINE. Su eficiencia aumenta a medida que se utiliza en poblaciones con menor edad media y, probablemente, en aquellas con mayor riesgo de desarrollar complicaciones GI.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Non-steroidal anti-inflammatory drugs (NSAIDs), used for the treatment of osteoarthritis, can produce serious gastrointestinal (GI) adverse reactions.</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Celecoxib, a specific COX-2 inhibitor, has a proven efficacy equivalent to that of traditional NSAIDs with an improved tolerance and safety profile.</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">The objective of this study was to perform a costeffectiveness analysis on the use of celecoxib versus traditional NSAIDs in the treatment of osteoarthritis.</p> <span class="elsevierStyleSectionTitle">Material and Methods</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">This cost-effectiveness analysis was designed through a pharmacoeconomic model; each effectiveness unit was defined as each year of life gained after the ingestion of celecoxib or NSAIDs. The probability of different clinical results appearing was obtained from published articles and incorporated assumptions.</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Only direct medical costs were evaluated (medication, hospitalization, additional tests, analyses, extra visits, etc.) and other costs were excluded.</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">The study perspective was the national health system and the time horizon chosen was 6 months.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">The additional cost for each year of life gained through the use of celecoxib compared with that of traditional NSAIDs amounted to 8017 € (1,333,834 ptas). Sensitivity analysis demonstrated how these values were sensitive to changes in the costs of NSAIDs and gastroprotective agents as well as to the inclusion of younger population groups.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Celecoxib can be considered as a cost-effective option in the treatment of osteoarthritis because its use prevents deaths and increases survival rate and the additional cost is reasonable and moderate compared with that of NSAIDs. Its efficiency increases in proportion to its use in younger patients and probably in those at high risk for developing GI complications.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:59 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 6 | 4 | 10 |
| 2024 Octubre | 56 | 36 | 92 |
| 2024 Septiembre | 41 | 22 | 63 |
| 2024 Agosto | 53 | 34 | 87 |
| 2024 Julio | 41 | 33 | 74 |
| 2024 Junio | 40 | 22 | 62 |
| 2024 Mayo | 38 | 18 | 56 |
| 2024 Abril | 32 | 15 | 47 |
| 2024 Marzo | 45 | 32 | 77 |
| 2024 Febrero | 38 | 36 | 74 |
| 2024 Enero | 32 | 17 | 49 |
| 2023 Diciembre | 39 | 34 | 73 |
| 2023 Noviembre | 30 | 17 | 47 |
| 2023 Octubre | 48 | 20 | 68 |
| 2023 Septiembre | 50 | 26 | 76 |
| 2023 Agosto | 31 | 21 | 52 |
| 2023 Julio | 40 | 26 | 66 |
| 2023 Junio | 40 | 18 | 58 |
| 2023 Mayo | 25 | 30 | 55 |
| 2023 Abril | 33 | 22 | 55 |
| 2023 Marzo | 35 | 37 | 72 |
| 2023 Febrero | 31 | 20 | 51 |
| 2023 Enero | 28 | 27 | 55 |
| 2022 Diciembre | 36 | 42 | 78 |
| 2022 Noviembre | 44 | 41 | 85 |
| 2022 Octubre | 30 | 26 | 56 |
| 2022 Septiembre | 27 | 43 | 70 |
| 2022 Agosto | 41 | 67 | 108 |
| 2022 Julio | 30 | 44 | 74 |
| 2022 Junio | 27 | 39 | 66 |
| 2022 Mayo | 42 | 38 | 80 |
| 2022 Abril | 27 | 38 | 65 |
| 2022 Marzo | 30 | 39 | 69 |
| 2022 Febrero | 28 | 29 | 57 |
| 2022 Enero | 23 | 40 | 63 |
| 2021 Diciembre | 26 | 33 | 59 |
| 2021 Noviembre | 29 | 49 | 78 |
| 2021 Octubre | 33 | 46 | 79 |
| 2021 Septiembre | 21 | 38 | 59 |
| 2021 Agosto | 18 | 34 | 52 |
| 2021 Julio | 16 | 28 | 44 |
| 2021 Junio | 20 | 38 | 58 |
| 2021 Mayo | 22 | 38 | 60 |
| 2021 Abril | 58 | 47 | 105 |
| 2021 Marzo | 49 | 25 | 74 |
| 2021 Febrero | 16 | 23 | 39 |
| 2021 Enero | 24 | 18 | 42 |
| 2020 Diciembre | 17 | 22 | 39 |
| 2020 Noviembre | 19 | 20 | 39 |
| 2020 Octubre | 19 | 20 | 39 |
| 2020 Septiembre | 12 | 14 | 26 |
| 2020 Agosto | 14 | 19 | 33 |
| 2020 Julio | 14 | 15 | 29 |
| 2020 Junio | 16 | 14 | 30 |
| 2020 Mayo | 9 | 13 | 22 |
| 2020 Abril | 16 | 11 | 27 |
| 2020 Marzo | 12 | 6 | 18 |
| 2020 Febrero | 18 | 27 | 45 |
| 2020 Enero | 16 | 18 | 34 |
| 2019 Diciembre | 10 | 14 | 24 |
| 2019 Noviembre | 15 | 6 | 21 |
| 2019 Octubre | 15 | 5 | 20 |
| 2019 Septiembre | 9 | 7 | 16 |
| 2019 Agosto | 15 | 13 | 28 |
| 2019 Julio | 7 | 6 | 13 |
| 2019 Junio | 8 | 8 | 16 |
| 2019 Mayo | 14 | 6 | 20 |
| 2019 Abril | 11 | 6 | 17 |
| 2019 Marzo | 7 | 8 | 15 |
| 2019 Febrero | 10 | 11 | 21 |
| 2019 Enero | 13 | 15 | 28 |
| 2018 Diciembre | 12 | 13 | 25 |
| 2018 Noviembre | 30 | 9 | 39 |
| 2018 Octubre | 70 | 24 | 94 |
| 2018 Septiembre | 34 | 25 | 59 |
| 2018 Agosto | 15 | 10 | 25 |
| 2018 Julio | 27 | 9 | 36 |
| 2018 Junio | 23 | 12 | 35 |
| 2018 Mayo | 29 | 11 | 40 |
| 2018 Abril | 28 | 9 | 37 |
| 2018 Marzo | 27 | 7 | 34 |
| 2018 Febrero | 17 | 11 | 28 |
| 2018 Enero | 11 | 13 | 24 |
| 2017 Diciembre | 22 | 14 | 36 |
| 2017 Noviembre | 11 | 11 | 22 |
| 2017 Octubre | 14 | 16 | 30 |
| 2017 Septiembre | 13 | 12 | 25 |
| 2017 Agosto | 8 | 7 | 15 |
| 2017 Julio | 17 | 15 | 32 |
| 2017 Junio | 23 | 27 | 50 |
| 2017 Mayo | 15 | 9 | 24 |
| 2017 Abril | 22 | 7 | 29 |
| 2017 Marzo | 17 | 14 | 31 |
| 2017 Febrero | 6 | 4 | 10 |
| 2017 Enero | 8 | 9 | 17 |
| 2016 Diciembre | 27 | 9 | 36 |
| 2016 Noviembre | 25 | 9 | 34 |
| 2016 Octubre | 29 | 16 | 45 |
| 2016 Septiembre | 32 | 26 | 58 |
| 2016 Agosto | 38 | 16 | 54 |
| 2016 Julio | 30 | 25 | 55 |
| 2016 Febrero | 1 | 0 | 1 |
| 2015 Diciembre | 1 | 0 | 1 |
| 2015 Septiembre | 1 | 0 | 1 |
| 2015 Julio | 1 | 0 | 1 |
| 2015 Junio | 2 | 0 | 2 |
| 2015 Abril | 4 | 0 | 4 |
| 2015 Marzo | 4 | 0 | 4 |
| 2015 Febrero | 2 | 0 | 2 |
| 2015 Enero | 4 | 0 | 4 |
| 2014 Diciembre | 9 | 0 | 9 |
| 2014 Noviembre | 7 | 0 | 7 |
| 2014 Octubre | 11 | 0 | 11 |
| 2014 Septiembre | 11 | 1 | 12 |
| 2014 Agosto | 19 | 2 | 21 |
| 2014 Julio | 14 | 0 | 14 |
| 2014 Junio | 13 | 0 | 13 |
| 2014 Mayo | 10 | 1 | 11 |
| 2014 Abril | 7 | 0 | 7 |
| 2014 Marzo | 5 | 1 | 6 |
| 2014 Febrero | 16 | 2 | 18 |
| 2014 Enero | 15 | 1 | 16 |
| 2013 Diciembre | 13 | 1 | 14 |
| 2013 Noviembre | 28 | 2 | 30 |
| 2013 Octubre | 53 | 6 | 59 |
| 2013 Septiembre | 44 | 5 | 49 |
| 2013 Agosto | 46 | 6 | 52 |
| 2013 Julio | 26 | 1 | 27 |
| 2003 Enero | 2534 | 0 | 2534 |
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