The cost-effectiveness of aspirin versus cyclooxygenase-2-selective inhibitors for colorectal carcinoma chemoprevention in healthy individuals

Cancer
Chin HurG Scott Gazelle

Abstract

Aspirin therapy is accepted widely for secondary prevention in patients with documented cardiovascular disease, but there is a growing trend among healthy individuals to use aspirin as primary chemoprevention for both cardiovascular and oncologic diseases. Accruing evidence suggests that cyclooxygenase-2-selective inhibitors (coxibs) may be effective for colorectal carcinoma (CRC) chemoprevention but would not provide the primary cardiac benefit of aspirin. A computer-based Markov model simulated hypothetical cohorts of healthy men age 50 years who took either 325 mg of enteric-coated aspirin daily or celecoxib at a dose of 400 mg twice a day. Patients in both cohorts could develop drug-related complications that would lead to its discontinuation. The aspirin group also was modeled to have a decreased rate of coronary ischemic events; however, decreased CRC mortality was not modeled in either group based on the assumption that the two treatments were effective equally in this regard. Data sources included published literature and the Centers for Medicare and Medicaid Services. Endpoints used to compare the two strategies included quality-adjusted life years (QALYs), mortality and complication rates, and cost. The analysis was f...Continue Reading

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Citations

Dec 6, 2008·Digestive Diseases and Sciences·Chin HurG Scott Gazelle
Apr 1, 2008·International Journal of Clinical Practice·C J SmithM Fisher
Aug 27, 2009·Cancer Research and Treatment : Official Journal of Korean Cancer Association·Sung-Jig LimSung Il Choi
Apr 21, 2009·Pharmacogenomics·Sonja Andersen, Frank Skorpen
Nov 12, 2009·Future Oncology·Setsuko K Chambers
Jul 9, 2005·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Mark A Hull
Sep 9, 2008·The American Journal of Gastroenterology·Chin HurG Scott Gazelle
Dec 16, 2006·World Journal of Gastroenterology : WJG·Hong-Chuan ZhaoGui-Hua Chen

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