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Initial patterns of use of COX-2 inhibitors by elderly patients in Ontario: findings and implications


Cyclooxygenase-2 (COX-2) inhibitors are a group of nonsteroidal anti-inflammatory drugs (NSAIDs) that may reduce the incidence of gastrointestinal side effects associated with nonselective NSAIDs. The COX-2 inhibitors celecoxib (Celebrex) and rofecoxib (Vioxx) were first listed on the Ontario Drug Benefit (ODB) formulary on Apr. 17, 2000, as “limited use” products. Limited use means that these products are covered as a benefit only if the prescribing physician completes a form indicating that previous NSAID therapy failed or was not tolerated by the patient or that the patient has a documented history of clinically significant gastrointestinal bleeding or ulcer. This paper provides information on the impact of the ODB listing of COX-2 inhibitors on the costs and quantity of overall NSAID prescriptions and describes some characteristics of patients who received COX-2 inhibitors as compared with those who received nonselective NSAIDs. The analysis uses claims routinely submitted by pharmacies for all prescription drugs provided under the universal ODB plan for elderly patients in Ontario, physician claims submitted to the Ontario Health Insurance Plan (OHIP) and census data.



Mamdani M, Rochon P, Laupacis A, Anderson G. CMAJ. 2002; 167(10):1125-6.

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