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Jake Jacobs, MPA
Center for Economic Studies in Medicine Reston, Va

JAMA. 1991;265(5):594.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I find it disconcerting that the only two studies of the economic impact of misoprostol could provide such disparate results. Hillman and Bloom¹ conclude that misoprostol is actually cost-reducing; they report that the drug more than pays for itself through reduced morbidity. In contrast, Edelson et al² estimate that (for the general population of NSAID users) it is necessary to spend $667 400 to save a year of life via a reduction in fatal gastrointestinal tract (GI) bleeds.

I confess that I had some difficulty following the calculations in the article by Edelson et al. It appears, however, that the following assumptions are used to estimate the effectiveness of misoprostol.

The annual rate of GI tract bleeds in NSAID users is 45 per 1000; the risk of death for patients who suffer a GI tract bleed is 11.2 per 1000. Misoprostol reduces the risk of . . . [Full Text PDF of this Article]

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