The cost of NSAID adverse events
January 25, 2005 15:56

For the NHS this has been explored in a recent economic analysis [8]. There are two main costs - those of hospital admissions with NSAID-related gastrointestinal bleeding, and the use of co-prescribing with acid-suppressing medicines.... http://www.jr2.ox.ac.uk/bandolier/booth/painpag/nsae/nsae.html#Heading15

Most (63%) of the physicians approached agreed to participate, ranging from 40% of community-based GPs to 100% of academic affiliated GPs. There were 312 visits to 112 physicians, and in 36 cases (12%) the physician unblinded the study by guessing that s/he was seeing a standardised patient (real patients were suspected only twice). ... http://www.jr2.ox.ac.uk/bandolier/booth/painpag/nsae/nsae.html#Heading5

NSAIDs are recognised as effective analgesics in acute and chronic pain and this is reflected in the NNT league table and in individual reviews. The evidence of effectiveness for NSAIDs is overwhelming when the test is comparison against placebo in acute or chronic conditions. But when it comes to which NSAID is the best in chronic conditions, we are in trouble.... http://www.jr2.ox.ac.uk/bandolier/booth/painpag/nsae/nsae.html

In using NSAIDs, we try to balance their benefits and harms. Most guidance stresses the use of simple analgesics, like paracetamol (acetaminophen) as a first line treatment for chronic conditions, with NSAIDs used later, perhaps with some protective agent to try to prevent gastrointestinal harm in those most at risk.... http://www.jr2.ox.ac.uk/bandolier/booth/painpag/nsae/nsae.html#Heading2

Got arthritis pain? How about severe headaches? If so, get ready for requests to take part in experimental drug testing. Heightened concerns about drug safety is about to boost the demand for patients willing to be guinea pigs.

Tips on how to find a Bextra lawyer can be found in this Article: Find a Bextra Lawyer.

http://www.signonsandiego.com/uniontrib/20050129/news_1n29drugs.html
Kaiser Permanente, one of the nation's largest managed-care organizations, has ordered its pharmacies to stop dispensing Bextra, an arthritis and pain drug made by Pfizer that some tests have indicated may increase the risk of heart attacks and strokes.

Bextra is in the same class of drugs, known as COX-2 inhibitors, as another Pfizer painkiller, Celebrex, that has also been found to pose cardiac risks at high doses, and Vioxx, the drug that Merck pulled from the market last fall after its own tests disclosed cardiac risks

Kaiser Permanente has told its pharmacies to stop dispensing Pfizer Inc.'s arthritis painkiller Bextra, the New York Times reported Saturday.

Officials of the nation's largest managed-care organization told the Times this marks the first time it has banned use of a drug approved by the U.S. Food and Drug Administration. Bextra, along with Vioxx and Celebrex, belong to a class of drugs known as cox-2 inhibitors. All three have shown an increased risk of cardiovascular trouble in those who take them. Vioxx was pulled from the market by its maker, Merck & Co., last September. Celebrex, another Pfizer drug, remains on pharmacy shelves.

Kaiser said that its Bextra ban would take effect on Feb. 1 for new prescriptions and March 1 for refill prescriptions.

Dr. Sharon Levine, associate executive director of the company's Northern California unit, said Kaiser physicians had already avoided using Bextra. But "for safety and quality reasons, we don't want to be involved in dispensing this drug," she told the Times.

Pfizer admitted last fall that studies showed Bextra posed an increased risk of heart attack and stroke among patients who have had coronary artery bypass surgery. Many experts have speculated that its risks could be as high as Vioxx's, according to the Times. Kaiser doctors will continue prescribing Celebrex in low doses, company officials said. The ban will take effect on Feb. 1 for new prescriptions and March 1 for refills.

The U.S. Food and Drug Administration has counseled physicians to limit prescriptions of both Bextra and Celebrex, and the agency has scheduled a three-day hearing of independent experts next month to discuss the benefits and dangers of all three painkillers. That panel is expected to recommend how the medicines should be regulated.