Objective: This study aimed to compare the prescription costs of specific cyclooxygenase-2 (COX-2) inhibitors, conventional non-steroid anti-inflammatory drugs (NSAID) in combination with proton pump inhibitors (PPI) or misoprostol for the treatment of osteoarthritis, using cost-minimization analysis.

Method: A modeling was used for cost-minimization analysis. In this model, daily prescription costs were compared, suggesting that treatment alternatives in osteoarthritis (COX-2 inhibitors, conventional NSAID plus PPI or misoprostol) are equally effective and safe. The daily prescription costs were calculated according to the prices of all drugs in TL as of Feb 2003, and in ¢(cent)/day, according to the USD/TL exchange rate in the same period. In order to calculate daily prescription cost, first of all ¢/mg of each drug was calculated, afterward average mg use for each drug was multiplied by this ¢/mg value. The data collected on NSAID and gastroprotective drug utilization from 3449 cases out of 3755 patients enrolled in the Osteoarthritis Pharmacoepidemiological Research (ART) between May 2002 and Jan 2003 were evaluated to calculate the daily prescription cost.

Results: Regarding daily prescription cost, the dominant alternative celecoxib was shown to be more economical than rofecoxib, conventional NSAII and PPI or misoprostol combination (44%, 8% and 18% less, respectively).

Conclusion: In this study, celecoxib was shown to be advantageous regarding prescription cost, within the comparable treatment alternatives in osteoarthritis, and it may reduce the economic burden both on the health care services and the public