Table 6.
Cost effectiveness on the basis of three months of treatment, base case assumptions*
| Cost per 10<thin>000 people treated (£) | QALYs gained per 10<thin>000 people treated | ICER† (£ per QALY) | Comparator | |
|---|---|---|---|---|
| People at low risk of gastrointestinal and cardiovascular adverse events (age 55 with no risk factors) | ||||
| No treatment | 0 | 0.0 | - | - |
| Paracetamol (3000 mg)§ | 127 708 | 10.0 | - | - |
| Diclofenac (100 mg) plus proton pump inhibitor | 198 117 | 28.4 | 6964 | No treatment |
| Naproxen (750 mg) plus proton pump inhibitor§ | 298 657 | 35.2 | - | - |
| Ibuprofen (1200 mg) plus proton pump inhibitor§ | 350 864 | 39.1 | - | - |
| Etoricoxib (30 mg) plus proton pump inhibitor | 580 668 | 72.9 | 7472 | Diclofenac (100 mg) plus proton pump inhibitor |
| Celecoxib (200 mg) plus proton pump inhibitor | 790 859 | 92.5 | 10 745 | Etoricoxib (30 mg) plus proton pump inhibitor |
| People at high risk of gastrointestinal and cardiovascular adverse events (age 65 or with risk factors) | ||||
| No treatment | 0 | 0.0 | - | - |
| Paracetamol (3000 mg)§ | 127 965 | 10.9 | - | - |
| Diclofenac (100 mg) plus proton pump inhibitor‡ | 230 640 | −26.0 | - | - |
| Naproxen (750 mg) plus proton pump inhibitor‡ | 352 079 | −32.5 | - | - |
| Ibuprofen (1200 mg) plus proton pump inhibitor‡ | 441 537 | −23.6 | - | - |
| Etoricoxib (30 mg) plus proton pump inhibitor§ | 600 650 | 46.3 | - | - |
| Celecoxib (200 mg) plus proton pump inhibitor | 841 035 | 80.4 | 10 458 | No treatment |
*Note that the results presented here do not exactly match those presented in Osteoarthritis: National clinical guideline for care and management in adults, Appendix D. This is owing to minor data input changes and also because the model was re-run with etoricoxib 30 mg plus proton pump inhibitor included in the base case analysis.
†Incremental cost effectiveness ratio (ICER): additional cost per additional quality adjusted life year (QALY) gained comparing each non-dominated option with the next most expensive, non-dominated option.
‡Treatment subject to “simple dominance”: another option is less expensive and more effective.
§Treatment subject to “extended dominance”: a combination of two other options is less expensive and more effective.