An Assessment of the Effectiveness of a Nonsteroidal Anti-inflammatory Drugs Algorithm in an Integrated Health Care System

RESULTS: The utilization of NSAIDs per member per month for both brandname and generic NSAIDs decreased significantly after implementation of the algorithm. The mean PMPM cost to the plan for NSAIDs also decreased significantly. However, while the NSAID acquisition cost for the plan decreased, the charges associated with treating NSAID-related adverse events showed an upward trend over the same period. CONCLUSIONS: The algorithm urged physicians to encourage patients to use over-the-counter NSAID medications as initial treatment. To the extent that the algorithm reduced the physicians’ and pharmacists’ involvement in the pharmaceutical care of the patient, the algorithm may have exposed patients to risks associated with inappropriate self-medication. In addition, the decrease in NSAID costs may have been offset by the increases in costs associated with treating NSAID-related adverse events.