Uso dei nuovi farmaci antinfiammatori non steroidei in medicina generale: Revisione critica degli studi Italiani di farmacoeconomia

Objective. To assess the validity of economic evaluations (EEs) published in Italy on non-steroidal anti-inflammatory drugs (NSAIDs) between 2000-2005. Methods. Pharmacoeconomic studies were searched for in two international databases (Embase, Medline) and the internal CESAV database using the keywords "NSAIDs", "osteoarthntis", "Italy" and "cost". Results. Only four studies were reviewed. The main clinical hypothesis, assuming that the different NSAIDs were substantially equivalent in terms of efficacy, concerned a different tolerability profile in the symptomatic treatment of osteoarthntis and rheumatoid arthntis. The type of EE used in the studies was cost minimisation analysis (CMA). All EEs analysed were performed from the Italian National Health Service's (NHS) perspective and all were short-term analyses. Three EEs out of four used modelling techniques. Two EEs estimated resource consumption through assumptions, a third based the economic analysis on medical records, and the fourth combined published data and assumptions. In almost all the EEs the sources of unit costs were drug prices and costs of inpatient and outpatient care. Three studies were supported by pharmaceutical companies, while the fourth did not declare sponsorship. Conclusions. From the review's results, no useful and dependable conclusions can be drawn as to which NSAIDs health professionals should chose in their clinical practice.