PHARMACOECONOMIC ANALYSIS OF CHRONIC NON-CANCER PAIN MANAGEMENT IN PATIENTS WITH COMORBID GASTROINTESTINAL PATHOLOGY
DOI: 10.22138/2500-0918-2026-23-1-71-78
Yu.A. Bogdanova¹, O.V. Kudelina², V.A. Kataev¹, R.Z. Nurlygayanov¹,³
¹Bashkir State Medical University, Ufa, Russian Federation
²Siberian state medical university, Tomsk, Russian Federation
³Limited Liability Company “Expert Clinic Ufa”, Ufa, Russian Federation
Abstract. Objective. The aim of the study was to conduct a pharmacoeconomic analysis of treatment strategies for chronic non-cancer pain in patients with comorbid gastrointestinal pathology. Materials and Methods. Based on a systematic review of the literature, the cost, efficacy, and safety of various therapeutic options used in the management of chronic pain in patients with musculoskeletal disorders and concomitant gastrointestinal diseases were evaluated. Results. It was shown that for medium-risk patients, the most cost-effective strategy is the combination of a non-selective nonsteroidal anti-inflammatory drug with a proton pump inhibitor. A fixed NSAID/PPI combination becomes economically justified when its cost decreases or when adherence to separate drug administration is low. The use of topical NSAID formulations demonstrates a favorable safety profile and represents a cost-effective alternative, particularly in older patients with high comorbidity. In patients at high risk of gastrointestinal bleeding, both combined NSAID + PPI therapy and selective cyclooxygenase-2 inhibitors, including celecoxib, may be economically effective. Conclusions. The pharmacoeconomic analysis confirms the feasibility of an individualized approach to choosing analgesic therapy for patients with chronic pain and comorbid gastrointestinal pathology, requiring consideration of clinical efficacy, safety, and the cost-effectiveness balance of different therapeutic strategies
Keywords: chronic pain, pharmacoeconomics, gastrointestinal tract, NSAIDs, gastroprotection
There is no conflict of interest.
Contact information of the author responsible for correspondence:
Yuliya A. Bogdanova
juladoctor@mail.ru
Received 19.11.2025
For citation: Bogdanova Yu.A., Kudelina O.V., Kataev V.A., Nurlygayanov R.Z. Pharmacoeconomic analysis of chronic non-cancer pain management in patients with comorbid gastrointestinal pathology [Online] Vestn. Ural. Med. Akad. Nauki. = Journal of Ural Medical Academic Science. 2026, Vol. 23, no. 1, pp. 71–78. DOI: 10.22138/2500-0918-2026-23-1-71-78 (In Russ)
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Authors
Yuliya A. Bogdanova
Candidate of Medical Sciences, Associate Professor
Bashkir State Medical University, Ufa, Russian Federation
juladoctor@mail.ru
Olga V. Kudelina
Doctor of Medical Sciences, Associate Professor
Siberian state medical university, Tomsk, Russian Federation
kudelina.ov@ssmu.ru
ORCID: 0000-0003-2921-3272
Valeriy A. Kataev
Bashkir State Medical University, Ufa, Russian Federation
Professor, Doctor of Pharmaceutical Sciences
centreles@mail.ru
Radik Z. Nurlygayanov
Candidate of Medical Sciences
Bashkir State Medical University, Ufa, Russian Federation
Limited Liability Company “Expert Clinic Ufa”
Ufa, Russian Federation
RNurlygayanova@mrtexpert.ru