Omeprazole vs Ranitidine in Reflux Oesophagitis in Sweden
- 6 Downloads
This study compared the cost-effectiveness of 2 strategies for the treatment of reflux oesophagitis. In the first strategy, treatment began with ranitidine 300mg daily for 8 weeks. The alternative strategy began with omeprazole 20mg daily for 4 weeks, and continued with another 4 weeks of omeprazole 20mg daily if patients were unhealed after the first 4 weeks. Those who remained unhealed in both groups after 8 weeks of treatment were administered omeprazole 40mg once daily for 4 weeks. The average cost of treatment and follow-up endoscopies per healed week was Swedish krona (SEK)l 140 ($US1 = SEK8) in the ranitidine group, whereas with omeprazole treatment the average cost per healed week was SEK622. The omeprazole strategy was more effective (6.75 healed weeks in a 12-week period) than ranitidine (3.71 healed weeks) and, despite a higher daily cost of treatment, omeprazole resulted in a lower average cost per patient. Sensitivity analysis showed that the conclusion regarding omeprazole being more cost-effective than ranitidine was insensitive to all reasonable changes in the cost parameters. Healing rates from 3 clinical trials also support the robustness of the conclusion in terms of the effect parameter.
KeywordsOmeprazole Ranitidine Healing Rate Reflux Oesophagitis Ranitidine 150mg
Unable to display preview. Download preview PDF.
- Bate CM, Crowe JP, Dickinson RJ, Green JRB, Smith PM, et al. Reflux esophagitis resolves more rapidly with omeprazole 20mg once daily than with ranitidine 150mg twice daily: omeprazole 40mg once daily provides further benefit in unresponsive patients. British Journal of Clinical Research 2: 133–148, 1991Google Scholar
- Bate CM, Keeling PWN, O’Morain C, Wilkinson SP, Foster DN, et al. Comparison of omeprazole and cimetidine in reflux oesophagitis: symptomatic, endoscopic, and histological evaluations. Gut 31: 969–972, 1990Google Scholar
- Blum AL, Wienbeck M, Schiessel R, Carlsson R. Omeprazole is superior to ranitidine in the treatment of reflux esophagitis. Hepato-Gastroenterology 36: 279, 1989Google Scholar
- Koelz HR. Treatment of reflux esophagitis with H2-blockers, antacids and prokinetic drugs. An analysis of randomized clinical trials. Scandinavian Journal of Gastroenterology 156 (Suppl.): 25–36, 1989Google Scholar
- Lindberg G, Lindström E, Marke LA, Nyren O, Seensalu R. Gastroskopi vid utredning av ont i magen. Stockholm: The Swedish Council on Technology Assessment in Health Care: 15–124, 1990Google Scholar
- Lindberg G, Lundquist P, Seensalu R, Linden B, Nilsson LH. Prospective evaluation of ‘GLADYS’ — a system for computer assisted diagnosis of dyspepsia. Theoretical Surgery 7: 169–176, 1992Google Scholar
- Zeitoun P, Rampal P, Barbier P, Isal JP, Eriksson S, et al. Omeprazole (20 mg/day) compared with ranitidine (150mg twice daily) in the treatment of reflux oesophagitis. Results of a randomised double-blind multicentre Franco-Belgian trial. Gastroenterologie Clinique et Biologique 13: 457–462, 1989PubMedGoogle Scholar