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ARTICLE |

The Cost-effectiveness of Misoprostol FREE

Alan L. Hillman, MD, MBA; Bernard S. Bloom, PhD
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Edited by Drummond Rennie, MD, Deputy Editor (West), and Don Riesenberg, MD, Senior Editor.


JAMA. 1991;265(5):593-593. doi:10.1001/jama.1991.03460050047010
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To the Editor.—  We commend Edelson et al1 on a thoughtful economic analysis of misoprostol, parts of which extend and corroborate our earlier work.2 We agree that the most robust science is produced when different investigators approach a question in different ways and come to similar conclusions, which is indeed the case with portions of our two studies.3There is one published, randomized, controlled clinical trial of misoprostol for prophylaxis of gastric ulcer, in which all patients had multiple endoscopies.4 In this 3-month trial, all of the several hundred patients with osteoarthritis had abdominal pain attributed to use of nonsteroidal anti-inflammatory drugs (NSAIDs) (but no gastric ulcer on endoscopy on entry to the study). The statements of Edelson et al about our interpretation of these data are incorrect. We calculated the relative risk of gastric ulcer in patients receiving misoprostol compared with the control group to

REFERENCES

Edelson JT, Tosteson ANA, Sax P.  Cost-effectiveness of miscprostol for prophylaxis against nonsteroidal anti-inflammatory drug-induced gastrointestinal tract bleeding . JAMA . 1990;;264:41-47.
Hillman AL, Bloom BS.  Economic effects of prophylactic use of misoprostol to prevent gastric ulcer in patients taking nonsteroidal anti-inflammatory drugs . Arch Intern Med. 1989;; 149:2061-2065.
Beck JR.  How to evaluate drugs: cost-effectiveness analysis JAMA . 1990;;264:83-84.
Graham DY, Agrawal NM, Roth SH.  Prevention of NSAID-induced gastric ulcer with misoprostol: multicent re, double-blind, placebo-controlled trial . Lancet. 1988;;2:1277-1280.

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Edelson JT, Tosteson ANA, Sax P.  Cost-effectiveness of miscprostol for prophylaxis against nonsteroidal anti-inflammatory drug-induced gastrointestinal tract bleeding . JAMA . 1990;;264:41-47.
Hillman AL, Bloom BS.  Economic effects of prophylactic use of misoprostol to prevent gastric ulcer in patients taking nonsteroidal anti-inflammatory drugs . Arch Intern Med. 1989;; 149:2061-2065.
Beck JR.  How to evaluate drugs: cost-effectiveness analysis JAMA . 1990;;264:83-84.
Graham DY, Agrawal NM, Roth SH.  Prevention of NSAID-induced gastric ulcer with misoprostol: multicent re, double-blind, placebo-controlled trial . Lancet. 1988;;2:1277-1280.
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