Cost-effectiveness of generic celecoxib in knee osteoarthritis for average-risk patients: a model-based evaluation

Osteoarthritis and Cartilage
Elena LosinaJeffrey N Katz

Abstract

The cost-effectiveness of the recently-introduced generic celecoxib in knee OA has not been examined. We used the Osteoarthritis Policy (OAPol) Model, a validated computer simulation of knee OA, to evaluate long-term clinical outcomes, costs, and cost-effectiveness of generic celecoxib in persons with knee OA. We examined eight treatment strategies consisting of generic celecoxib, over-the-counter (OTC) naproxen, or prescription naproxen, with or without prescription or OTC proton-pump-inhibitors (PPIs) to reduce gastrointestinal (GI) toxicity. In the base case, we assumed that annual cost was $130 for OTC naproxen, $360 for prescription naproxen, and $880 for generic celecoxib. We considered a willingness-to-pay threshold of $100,000 per quality-adjusted life year (QALY) and discounted costs and benefits at 3% annually. In sensitivity analyses we varied celecoxib toxicity, discontinuation, cost, and pain level. In the base case analysis of the high pain cohort (WOMAC 50), celecoxib had an incremental cost-effectiveness ratio (ICER) of $284,630/QALY compared with OTC naproxen. Only under highly favorable cost, toxicity, and discontinuation assumptions (e.g., annual cost below $360, combined with a reduction in the cardiovascula...Continue Reading

Citations

Apr 3, 2021·Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders·Christopher VannabouathongMohit Bhandari
May 24, 2021·Osteoarthritis and Cartilage·V P LeiferE Losina
Aug 18, 2020·Arthritis Care & Research·Ting ZhaoAndrew J Palmer
Nov 11, 2020·Osteoarthritis and Cartilage·J K SullivanE Losina

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