Medical Evidence

Pharmaco-Economic Study: Evaluating Use Patterns And Economic Impact Of CS 4&6 In Real Life Setting Henry-Launois B, Aussage P, Launois R ARCOS, Issy les Moulineaux, France

Objective: Chondroitin sulfate (CS 4&6) is a slow-acting and well-tolerated symptomatic treatment of osteoarthritis (OA). Several randomized clinical trials proved that it was effective on pain and mobility, and allowed to lower the use of Non-Steroidal Anti-inflammatory Drugs (NSAID) in OA. The primary objective of the pharmaco-economic study was to reassess beneficial effect on prescribed volume of NSAIDs in OA (ICD-9-CM, code 715) under current practice conditions in France.

Methods: The analysis was based on two large French medical databases the comprehensive IMS Study of Drug Prescription and THALES panel of 300 general practitioners (GP), allowing dynamic analysis on 11,000 osteoarthritic patient records. We compared CS 4&6 and "other OA drugs" in terms of use patterns, ambulatory care resource utilization and particularly use of NSAlDs. Costs were valorized in the Health Insurance perspective.

Results: Both databases provided convergent evidence on the ability of CS 4&6 to reduce NSAiD consumption and lower ambulatory care costs. Average quantities of NSAID prescribed under CS 4&6 treatment, expressed in number of Daily Defined Doses (DIDD), are 2.7 times less important for general practitioners, and 6.7 times less important for specialists, as compared to the "other OA treatment" arm (IMS). THALES data showed a marked decrease in rate of NSAID prescriptions upon renewal of CS 4&6 treatment (10% versus 18%). Yearly ambulatory care costs were computed for CS 4&6 patients versus “the other treatment" group. Both groups were comparable as to sex, age, gastrointestinal risk factors, and average duration of observation Treating patients with CS 4&6 did not increase costs for the Health Insurance. The total average amount reimbursed per year for ambulatory care was FF 955 versus FF 920 in the compared group (n.s.). The expense for antiarthrosis medications was higher in the CS 4&6-treated cohort, but this was compensated by less gastrointestinal co-prescriptions and 50 % cut in physiotherapy costs, reflecting positive CS 4&6 effect on mobility and good tolerance observed in clinical trials.

Conclusion: This comprehensive database analysis proved a valuable tool for assessing CS 4&6 benefits in real life setting, confirming the efficacy proved by randomized clinical trial results.

Source: EULAR ’98 Symposium-Satellite IBSA Geneva, Sept. 7th, 1998 Satellite Symposium 10. New approaches in OA: chondroitin sulfate (CS 4&6) not just a symptomatic treatment T.L. Vischer, B.A. Michel (Chairs)

Dr. Theo’s Comments: This economic analysis shows that chondroitin sulfate is expensive but patients taking it had a markedly lower need for medication to offset the stomach problems from NSAIDs and a 50% reduction in physical therapy costs. Chondroitin for osteoarthritis is a good value.