Budget Impact Modeling for a Single-Tablet Formulation of Ibuprofen and Famotidine for Prevention of Upper Gastrointestinal Ulcers in Patients With Osteoarthritis and/or Rheumatoid Arthritis

Renee Kuan, Robert J. Holt, Kenneth E. Johnson, Jeffrey D. Kent, David A. Peura, Daniel C Malone

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Single-tablet ibuprofen/famotidine is approved by the US Food and Drug Administration for the relief of signs and symptoms of rheumatoid arthritis and osteoarthritis and to decrease the risk of developing upper gastrointestinal (GI) ulcers in patients taking ibuprofen for those indications. Currently, little is known about the cost impact of gastroprotective therapies, and an estimate of the financial consequences of adopting these therapies will be helpful to decision makers. Objectives: The goal of this study was to review a model that evaluates the expected financial impact to US health care plans from the introduction of single-tablet ibuprofen/famotidine into the chronic NSAID user population. Methods: A budget impact model, considering a typical health plan of 1 million enrollees, was used to compare patients receiving: (1) single-tablet ibuprofen/famotidine; (2) chronic NSAID treatment plus any GI-protective agent; and (3) chronic NSAID treatment without a GI-protective agent. Results: The expected medication cost for single-tablet ibuprofen/famotidine was $734,192 ($81,577 in year 1, $244,731 in year 2, and $407,884 in year 3), corresponding to a total per-member per-month cost of $0.020 ($0.007 in year 1, $0.020 in year 2, and $0.034 in year 3). Considering anticipated decreases in the use of other NSAIDs, the use of GI-protective agents, and GI complications, the total expected 3-year drug cost for single-tablet ibuprofen/famotidine was offset by 50%, representing an estimated total budget impact of $364,396 or $0.010 per member per month. Sensitivity analyses of cost and market share variables and clinical and drug characteristics identified the most influential variables to be the cost of the drug and persistence to the ibuprofen/famotidine formulation, respectively. Conclusions: The expected decrease in treatment costs for less serious GI-related complications illustrates the benefits of single-tablet ibuprofen/famotidine as a gastroprotective therapy in patients receiving chronic NSAID treatment, with a modest financial impact on total health care costs.

Original languageEnglish (US)
Pages (from-to)321-332
Number of pages12
JournalClinical Therapeutics
Volume35
Issue number3
DOIs
StatePublished - Mar 2013

Fingerprint

Famotidine
Ibuprofen
Budgets
Osteoarthritis
Tablets
Ulcer
Rheumatoid Arthritis
Non-Steroidal Anti-Inflammatory Agents
Gastrointestinal Agents
Protective Agents
Costs and Cost Analysis
Drug Costs
Health Care Costs
Therapeutics
United States Food and Drug Administration
Signs and Symptoms
Delivery of Health Care
Health

Keywords

  • Adherence
  • Budget impact model
  • Gastroprotection
  • H-receptor antagonist
  • Medication cost avoidance
  • NSAID

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Budget Impact Modeling for a Single-Tablet Formulation of Ibuprofen and Famotidine for Prevention of Upper Gastrointestinal Ulcers in Patients With Osteoarthritis and/or Rheumatoid Arthritis. / Kuan, Renee; Holt, Robert J.; Johnson, Kenneth E.; Kent, Jeffrey D.; Peura, David A.; Malone, Daniel C.

In: Clinical Therapeutics, Vol. 35, No. 3, 03.2013, p. 321-332.

Research output: Contribution to journalArticle

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abstract = "Background: Single-tablet ibuprofen/famotidine is approved by the US Food and Drug Administration for the relief of signs and symptoms of rheumatoid arthritis and osteoarthritis and to decrease the risk of developing upper gastrointestinal (GI) ulcers in patients taking ibuprofen for those indications. Currently, little is known about the cost impact of gastroprotective therapies, and an estimate of the financial consequences of adopting these therapies will be helpful to decision makers. Objectives: The goal of this study was to review a model that evaluates the expected financial impact to US health care plans from the introduction of single-tablet ibuprofen/famotidine into the chronic NSAID user population. Methods: A budget impact model, considering a typical health plan of 1 million enrollees, was used to compare patients receiving: (1) single-tablet ibuprofen/famotidine; (2) chronic NSAID treatment plus any GI-protective agent; and (3) chronic NSAID treatment without a GI-protective agent. Results: The expected medication cost for single-tablet ibuprofen/famotidine was $734,192 ($81,577 in year 1, $244,731 in year 2, and $407,884 in year 3), corresponding to a total per-member per-month cost of $0.020 ($0.007 in year 1, $0.020 in year 2, and $0.034 in year 3). Considering anticipated decreases in the use of other NSAIDs, the use of GI-protective agents, and GI complications, the total expected 3-year drug cost for single-tablet ibuprofen/famotidine was offset by 50{\%}, representing an estimated total budget impact of $364,396 or $0.010 per member per month. Sensitivity analyses of cost and market share variables and clinical and drug characteristics identified the most influential variables to be the cost of the drug and persistence to the ibuprofen/famotidine formulation, respectively. Conclusions: The expected decrease in treatment costs for less serious GI-related complications illustrates the benefits of single-tablet ibuprofen/famotidine as a gastroprotective therapy in patients receiving chronic NSAID treatment, with a modest financial impact on total health care costs.",
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