The efficacy of 400 micrograms
misoprostol daily in the prevention of
NSAID (non-steroidal anti-inflammatory
drug)-induced
gastric ulcer has been proven. We calculated the cost-effectiveness of a 3-month course of treatment of 200 micrograms twice daily for patients of the sick fund "Wiener Gebietskrankenkasse", based on charges of the year 1993. Since efficacy in preventing
NSAID-induced
gastric ulcers has not yet been proven for any other
drug, we compared
misoprostol-treated patients with untreated controls. The model was based on the following assumptions: 70% compliance with respect to
misoprostol treatment, 5.6% incidence of
gastric ulcer in patients protected with
misoprostol, 21.7% incidence among unprotected
NSAID users, 20% hospitalisation among patients with
gastric ulcer. When using "Kassenpreis" (
drug price paid by the sick funds)
misoprostol treatment is cost-effective at costs of AS 64,100,--for inpatient care, upwards and at costs of AS 43,361,-upwards when using "Apothekeneinstandspreis" (
drug price paid by pharmacies to wholesalers). In Austria costing system of inpatient care is based on a per diem fee. In 1993 the above costs corresponded to an average of 13 and 9 days, respectively, of inpatient care in Vienna. But costs of care increase by almost 25% per year and, hence, this conclusion is only temporarily valid and already in 1994 cost-effectiveness will be reached in less days of inpatient care. Sensitivity analysis shows that cost-effectiveness mainly varies according to the incidence of
gastric ulcer among unprotected adults, and the hospitalisation rate of
gastric ulcer patients. Efficacy (
gastric ulcer rate among
misoprostol treated patients) and compliance have a relatively low impact.(ABSTRACT TRUNCATED AT 250 WORDS)