[Cyclooxygenase-2 (Cox-2) selective inhibitors: socioeconomic and pharmaco-epidemiologic aspects]

Health authorities of several European countries recently introduced guidelines for socioeconomic evaluations. Additionally the activities of OMERACT (Outcome Measures in Rheumatoid Arthritis Clinical Trials) indicate an increasing awareness for the need of socioeconomic studies in rheumatology. The planned 2000 OMERACT meeting in Toulouse will address transfer of socioeconomic standards into rheumatology. In terms of cost effectiveness of selective Cox-2 inhibitors, a reference has to be made to the preceding discussion of cost effectiveness of Misoprostol. In addition, there are two models examining the cost effectiveness of Cox-2 inhibitors: a Canadian model comparing Nabumetone and Naproxen and an unpublished model assessing the cost effectiveness of Celecoxib (ACCES: Arthritis Cost Consequence Evaluation System). German data indicate that gastrointestinal bleedings account for 32.9% of all adverse drug events leading to a hospital admission. Further data assessing the morbidity due to adverse effects of nonsteroidal anti-inflammatory drugs are needed. Such data would allow the quantification of possible savings related to the usage of Cox-2 inhibitors in Germany.