Consider alternatives to high-cost combination NSAIDS


Did you know that single-pill combination non-steroidal anti-inflammatory drugs (NSAIDS) can cost $2,000 or more per prescription? If you are a provider who prescribes this medicine to workers’ compensation patients, you may want to consider an alternative.

As you know, NSAIDS help reduce pain and inflammation, but may have side effects and complications such as elevated blood pressure, the risk of gastrointestinal bleeding and cardiovascular events. NSAIDs should be used with the lowest dose and for the shortest duration.

Many providers prescribe combination NSAIDS to reduce the negative effects of NSAIDS. These medications combine an NSAID with a medication that protects the gastrointestinal system, particularly the gastric mucosa, into one. This can include combining an NSAID with a histamine (H2) blocker such as Zantac, proton pump inhibitors such as Vimovo (naproxen, esomeprazole) or other gastrointestinal-protective medications such as Duexis (ibuprofen, famotidine).

While most NSAIDS are relatively inexpensive, combination NSAIDS cost significantly more. Also, there’s no evidence that single-pill combination NSAIDS offer improved efficacy over alternative medicines or an NSAID taken with a gastro-protective medication.

If you believe a patient is at high risk for gastrointestinal irritation, consider prescribing an alternative medicine or a gastro-protective medication along with the NSAID.


This document contains references to brand name prescription medicines that are trademarks or registered marks of pharmaceutical manufacturers that are not affiliated with Horizon Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association.