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PharmacoEconomics

, Volume 11, Issue 4, pp 367–376 | Cite as

Cost-Effectiveness Analysis of Different Strategies for Treating Duodenal Ulcer

Helicobacter pylori Eradication versus Antisecretory Treatment
  • Xavier Badia
  • Josep Lluis Segú
  • Ariadna Ollé
  • Max Brosa
  • Joan Monés
  • Lorenzo García Ponte
Original Research Article

Summary

Helicobacter pylori has recently been recognised as a causative agent for duodenal ulcer, and the efficacy of various combinations of antibacterials and antisecretory agents in eradicating this pathogen has been assessed.

The objective of this study was to determine the efficiency of 2 treatment strategies for patients with H. pylori-positive duodenal ulcer. Cost effectiveness was analysed for antisecretory therapy (omeprazole 20 mg/day for 4 weeks), and eradication therapy (triple therapy: omeprazole 40 mg/day plus clarithromycin 1 g/day plus amoxicillin 2 g/day for 1 week).

In a Markov model, a hypothetical cohort of 5000 patients was followed for 10 years through 6 disease states. Cyclic eradication therapy (i.e. in the first duodenal ulcer episode and in relapses) was the most cost effective [21 Spanish pesetas (Pta) per day free of symptoms (DFS); Ptal28 = $USI (October 1995)] of the eradication options evaluated [antisecretory in the first episode, then eradication for relapses (Pta22.3/DFS), and eradication therapy first, then antisecretory therapy (Pta27.3/DFS)]. Antisecretory therapy alone was less cost-effective (Pta39/DFS) than each of the 3 eradication options. Eradication treatment in the first episode of duodenal ulcer and relapses has savings in direct costs per patient of up to 56% compared with antisecretory therapy alone. Sensitivity analyses showed the model to be very robust.

It is, therefore, advisable to treat initial episodes of H. pylori-positive duodenal ulcer and relapses with triple therapy. The improved cost-effectiveness ratio was largely explained by the long term reduction in relapses obtained with the eradication strategies.

Keywords

Omeprazole Duodenal Ulcer Triple Therapy Pylorus Eradication Eradication Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Copyright information

© Adis International Limited 1997

Authors and Affiliations

  • Xavier Badia
    • 1
  • Josep Lluis Segú
  • Ariadna Ollé
    • 1
  • Max Brosa
    • 2
  • Joan Monés
    • 3
  • Lorenzo García Ponte
    • 4
  1. 1.Institut de Salut Pública de CatalunyaUniversity of BarcelonaBarcelonaSpain
  2. 2.SOIKOSCentre for Health EconomicsBarcelonaSpain
  3. 3.Gastroenterology SectionHospital Santa Creu i Sant PauBarcelonaSpain
  4. 4.Medical DepartmentAbbott LaboratoriesMadridSpain

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