Switching the histamine H2 receptor antagonist famotidine to nonprescription status in Canada. An economic evaluation.

The aim of this study was to compare the direct medical costs associated with the treatment of patients with heartburn/nonulcer dyspepsia under 2 scenarios: (i) no nonprescription histamine H2 receptor antagonist (H2RA) is available (the 'status quo scenario'); and (ii) the H2RA famotidine (at a daily dosage of 10mg) is available over-the-counter (OTC) at retail pharmacies (the 'OTC scenario'). We employed a decision analysis model over a 16-week period that considered direct medical costs from 2 alternative perspectives: (i) society, including the cost of self-medication borne by patients; and (ii) a provincial third-party payer for healthcare. Data concerning direct medical costs associated with consumer self-medication and physician prescription of medication (including pharmacist dispensing fees), tests and procedures, and consultations with general practitioners and specialists were drawn from a clinician panel, published unit costs, and special surveys of institutional databases.

The economic consequences of NSAID-induced gastrointestinal damage.

The secondary gastrointestinal effects associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) are well documented in the medical literature. The "iatrogenic" cost arising from the treatment of these secondary effects, however, is less well known. Existing epidemiologic and clinical studies report that the cost of NSAIDs is multiplied by a coefficient that ranges from 1.