Tilden DP1, Schulz M2, Davey P1, Noble I2, 1M-TAG Pty Ltd, Chatswood, NSW, Australia; 2Merck Sharpe & Dohme (Australia) Ltd, Granville, NSW, Australia

OBJECTIVES: The aim of this study was to determine utility values for different health outcomes associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) or paracetamol in the treatment of osteoarthritis. METHODS: Six physicians and 73 nurses responded to a postal survey based on the EQ-5D. Health care professionals were considered an appropriate survey group because they have a good understanding of how the alternative health state scenarios would impact on patients. Five health states were defined based on published clinical trial data and expert opinion: 1) osteoarthritis patients managed with an NSAID who are free of gastrointestinal complications; 2) osteoarthritis patients managed with an NSAID who have minor NSAID-type gastrointestinal complications (eg, dyspepsia, reflux); 3) osteoarthritis patients managed with an NSAID who have an uncomplicated perforation, ulcer or bleed (PUB); 4) osteoarthritis patients managed with an NSAID who have a complicated PUB; and 5) osteoarthritis patients managed with paracetamol. Utility values were derived for each of the five health states based on the responses to the survey and the EQ-5D scoring algorithm. RESULTS: Patients without gastrointestinal side effects had the highest utility value (mean utility value: 0.667). Patients with complicated PUBs had the lowest utility (-0.151), while higher utilities were seen in patients with uncomplicated PUBs (0.456) and those with minor NSAID-type gastrointestinal complications (0.557). Patients whose osteoarthritis was managed with paracetamol had lower utility than those patients managed with traditional NSAIDs who are free of gastrointestinal complications - a result consistent with the relative efficacy of NSAIDs and paracetamol in the treatment of osteoarthritis. CONCLUSIONS: Therapies with lower rates of gastrointestinal-related toxicity can improve the quality of life of osteoarthritis sufferers. Our study enables new osteoarthritis treatments which offer lower rates of GI toxicity than traditional NSAIDs to be evaluated in a cost-utility framework.