Cyclooxygenase-2 inhibitors exhibit the same effectiveness on rheumatic symptoms as nonsteroidal anti-inflammatory drugs, have fewer gastrointestinal side effects, but a higher price. Based on cost and healthcare utilization in Norway, this paper explores what factors are most important for the cost-effectiveness of cyclooxygenase-2 inhibitors and points to patient groups that may be most relevant for prescribing coxibs instead of nonsteroidal anti-inflammatory drugs.