New Drug Introductions and the Cost of Ulcer in Sweden

Abstract

Early estimates of the economic consequences of cimetidine use indicated a cost reduction for the healthcare system and for society. A Swedish study based on registry data between 1973 and 1983 showed a net economic gain because the reduction in indirect costs (a decline in disability pensions and short term absence from work) exceeded the increase in direct costs. However, the increase in total costs for ulcer drugs at the time of introduction of cimetidine was higher than the reduction in costs due to a concurrent decrease in the number of major elective surgical interventions for peptic ulcer. Recent data show that the costs for drugs used in the treatment of peptic ulcer continue to grow. The total costs for drugs increased in fixed prices 3 times between 1984 and 1993, while the use of inpatient care and surgical interventions decreased. In 1981, the total number of major operations for gastric or duodenal ulcer in Sweden was 21.6 per 100 000 inhabitants. In 1991, the comparable figure was 6.3 operations. At the same time, the number of inpatient days was reduced by 30% because of shorter periods of hospitalisation, while the number of hospital admissions with peptic ulcer as the main diagnosis increased, especially in groups aged over 75 years. In younger age groups, the admission rate has been slightly reduced. The savings in hospital care as a result of fewer operations are probably small compared with the increased costs for drugs. The effect on other supplementary drugs (e.g. antacids), ambulatory care, and indirect costs has to be studied before conclusions can be drawn regarding the total effect of the introduction of new drugs in the treatment of peptic ulcer after 1983.