Elderly patient, struggling with multiple medications (pill bottles on a table), looking distressed as they contemplate NSAID risks. Background includes a clinical setting with charts showing economic impact. Focus on the expression of worry and vulnerability.
Non-steroidal anti-inflammatory drugs (NSAIDs) play a key role in alleviating pain and inflammation, but they also bring a substantial risk to vulnerable populations. This study provides insight into the cost to the NHS and the health burden caused by prescribing NSAIDs to patients in high-risk groups, such as older adults and those on anticoagulants.
The True Cost of High-Risk Prescriptions The findings from this research underscore a harsh reality—NSAIDs are responsible for significant healthcare costs and avoidable harm. “The most common issue we identified was in older adults without gastroprotection,” explains one of the researchers, Elizabeth M. Camacho. This led to a notable loss of quality-adjusted life years (QALYs) and millions in NHS expenses, particularly due to gastrointestinal bleeding and other severe side effects.
Vulnerable Groups at Greater Risk The study highlights that patients with conditions such as chronic kidney disease, heart failure, or a history of peptic ulcers face higher risks. Leonie S. Penner, another researcher involved in the study, noted, “We saw the greatest loss in QALYs and NHS costs in people taking anticoagulants simultaneously with NSAIDs.” The cumulative costs for the NHS amounted to millions over a decade, with harmful prescribing contributing significantly to healthcare strain.
An Unavoidable Healthcare Challenge Chronic conditions often require long-term medication, and NSAIDs, despite their known risks, are frequently prescribed. However, this research points to a clear need for more careful risk assessment before prescribing to vulnerable groups. “We estimated a total of 6335 QALYs lost over ten years due to hazardous NSAID prescribing,” said Anthony J. Avery, another co-author. He emphasized the financial toll this practice takes on the healthcare system.
Toward Safer Prescribing Practices Darren M. Ashcroft, one of the study’s authors, suggested that healthcare providers must adopt stricter measures to prevent hazardous prescribing. “It is essential to consider the risks associated with NSAID use in high-risk populations and take steps to minimize avoidable harm,” he said. The findings encourage a shift towards more tailored treatment approaches, reducing unnecessary harm in these vulnerable groups.
Citation:
Camacho EM, Penner LS, Taylor A, et al. Estimating the economic effect of harm associated with high risk prescribing of oral non-steroidal anti-inflammatory drugs in England: population based cohort and economic modelling study. BMJ. 2024;386. doi:10.1136/bmj-2023-077880.
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