Cost analysis of flavocoxid compared to naproxen for management of mild to moderate OA

Abstract

Objective:

Flavocoxid is a medical food used for the clinical dietary management of osteoarthritis (OA). The acquisition cost of flavocoxid is higher than most traditional, generic NSAIDs. However, flavocoxid may have more favorable gastrointestinal (GI) toxicity resulting in lower overall costs. These costs have not been previously examined. This study provides a decision analytic model to assess the net costs of using flavocoxid for OA from a Medicare perspective.

Research design and methods:

A decision model was developed to estimate the total costs associated with flavocoxid versus naproxen for the management of Medicare patients with mild to moderate OA. Probabilities were obtained from literature and expert opinion, and costs were obtained from Medicare. Sensitivity analyses were conducted by varying probabilities and costs within clinically relevant ranges.

Results:

The base case resulted in flavocoxid having lower total annual costs ($1482 per patient) compared to naproxen ($1592). Flavocoxid remained the lowest cost option when the cost inputs were varied by 25% (above and below the base case), and when the probability of GI events with flavocoxid were varied by 25%. However, when GI rates from the literature and implied relative risks from the expert panel were used, or if the cost of PPIs was $0, then naproxen was the less costly alternative, though saving less than the annual cost of flavocoxid. Key limitations were the limited outcomes in the model (only GI events), lack of consideration of adherence or combination therapy, and the reliance on expert opinion due to a lack of data for flavocoxid.

Conclusions:

In patients over 65 years of age who suffer from mild to moderate OA, flavocoxid may result in lower overall costs, despite a higher acquisition cost. Managed care organizations should consider total health care costs in the decision to include flavocoxid as a covered benefit.

Key words::

• Cost analysis
• Decision modeling
• Medical food
• Osteoarthritis

Transparency

Declaration of funding

This study was funded by Primus Pharmaceuticals, Inc., which provided input to the design of the study but was not involved in conducting the analyses and had no influence on the interpretation of results.

Declaration of financial/other relationships

S.W. and G.S. have disclosed that they were paid by Primus for conducting this study. D.M. has disclosed that he is a consultant for Primus and has a small minority stock holding in Primus and Pfizer. He also is on the speakers bureau of Primus and Victory Pharma.

Some peer reviewers receive honoraria from CMRO for their review work. The peer reviewers of this paper have disclosed that they have no relevant financial relationships.

Acknowledgment

The authors have disclosed that they had no outside editorial assistance in preparing this manuscript.

Notes

* Manufactured by Primus Pharmaceuticals, Scottsdale, AZ, USA.