The "limited use" designation indicated the products would only be covered as a benefit if previous NSAID therapy had failed or was not tolerated by a patient. However, based on their examination of drug claims data, Muhammad Mamdani and colleagues found that most of the patients among the initial users of COX-2 inhibitors did not have a prescription claim for another NSAID in the 4 months preceding their first COX-2 prescription.
The authors state that the listing of the COX-2 inhibitors had a "substantial and immediate impact on expenditures on NSAIDs," and accounted for 48% of prescriptions and 66% of expenditures for NSAIDs in the post-listing period (Apr. 18 to Nov. 30, 2000).
In a related editorial, James Wright describes the appropriate use of these medicines, the safety and efficacy of NSAIDs and the advantages and disadvantages of COX-2 inhibitors.
p. 1125 Initial patterns of use of COX-2 inhibitors by elderly patients in Ontario: findings and implications
-- M. Mamdani et al
p. 1131 The double-edged sword of COX-2
selective NSAIDs
-- J.M. Wright
Journal
Canadian Medical Association Journal