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Traditionelle NSAID-præparater vs COX-2 hæmmere. Baggrund Formål Forudsætninger Model. Resultater Sensitivitetsanalyse Konklusion Diskussion. Introduktion. NSAID smertelindrende effekt flere bivirkninger fra mave-tarm kan reduceres med PPI billigere. COX-2 hæmmere
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Traditionelle NSAID-præparater vsCOX-2 hæmmere MPH - Maj 2004
Baggrund Formål Forudsætninger Model Resultater Sensitivitetsanalyse Konklusion Diskussion Introduktion MPH - Maj 2004
NSAID smertelindrende effekt flere bivirkninger fra mave-tarm kan reduceres med PPI billigere COX-2 hæmmere samme smerte-lindrende effekt færre bivirkninger fra mave-tarm dyrere Baggrund MPH - Maj 2004
Formål • Hvad kan bedst betale sig, når patienter skal symptomlindres - skal lægerne ordinere NSAID eller COX-2 hæmmere ved smerter? MPH - Maj 2004
Forudsætninger • Målgruppe: 70 + år • NSAID præparat: Ibuprofen • COX-2 hæmmere: Celecoxib • PPI: Lanzoprazol • Tidsperspektiv: 6 måneder • Bivirkninger: efter 3 måneder MPH - Maj 2004
Model Model MPH - Maj 2004
Resultater • ICER ved behandling med COX-2 hæmmere: 2399.63 - 1069.14 / 0.00277 - 0.00146 = 814.000 kr. / QALY MPH - Maj 2004
Sensitivitetsanalyse • Ved valg af dyreste Ibuprofen(NSAID) og COX-2 hæmmer, er der ikke en væsentlig forskel på ICER: 909.000 kr. / QALY • Ved ændring i bivirkningshyppigheden ved NSAID til 75% (ifht. 35%) er ICER: 76.000 kr. / QALY MPH - Maj 2004
Konklusion • Det er ikke omkostningseffektivt at behandle med COX-2 hæmmere -analysen peger på NSAID som det sundhedsøkonomisk optimale valg • Hvis større bivirkningshyppighed ved behandling med NSAID, vil behandling med COX-2 hæmmere være omkostningseffektivt MPH - Maj 2004
Diskussion • Styrker • Svagheder • Valg af målgruppe • ASA • QALY/livskvalitet MPH - Maj 2004
Diskussion h MPH - Maj 2004
Gruppen • Hanne Rasmussen • Hanne Tårup • Lisbet Gamborg • Lise Bjørn Jacobsen • Jeanett L. Péronard MPH - Maj 2004
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