PMID: 8996045Jan 13, 1997Paper

Pharmacoeconomic comparison of treatments for the eradication of Helicobacter pylori

Archives of Internal Medicine
J L TaylorJ W Freston

Abstract

Patients with Helicobacter pylori-induced duodenal ulcer should have their infection eradicated. The optimal choice of antibiotic therapy, however, is less clear. To evaluate costs and outcomes of treatment with 8 antibiotic regimens with documented activity against H pylori vs maintenance therapy with histamine2-receptor antagonists (H2RA). A meta-analysis for 119 studies enrolling 6416 patients to determine aggregate eradication rates. The complexity of each regimen was used to determine the anticipated compliance rate and actual effectiveness. A decision analytic model with Monte Carlo simulation determined annual costs and health outcomes. Average annual total costs of testing for H pylori infection and antibiotic treatment ranged from $223 to $410 and prevented ulcer recurrence in 70% to 86% of patients. The H2RA maintenance therapy cost $425 and prevented recurrence in 72% of patients. The lowest costs and recurrence rates were achieved by 3 regimens: standard triple therapy (a combination of bismuth subsalicylate, metronidazole, and tetracycline hydrochloride) for 14 days ($223, with 18% recurrence); a combination of clarithromycin, metronidazole, and a proton pump inhibitor for 7 days ($235, with 15% recurrence); and st...Continue Reading

Citations

Oct 19, 1999·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J P Ioannidis, J Lau
Nov 27, 1998·The American Journal of Medicine·D Peura
Jun 30, 2001·Obstetrics and Gynecology Clinics of North America·S L Winbery, K E Blaho
Jan 16, 1998·The American Journal of Medicine·T R LevinJ V Selby
Jan 26, 2006·Expert Opinion on Pharmacotherapy·Karine Lamiraud, Jean-Paul Moatti
Jul 29, 1999·Medical Decision Making : an International Journal of the Society for Medical Decision Making·D J PastaJ M Henning
Feb 24, 1999·Journal of Gastroenterology and Hepatology·K L GohS M Raj
Dec 18, 2013·The Cochrane Database of Systematic Reviews·Yuhong YuanPaul Moayyedi
Aug 1, 2002·Expert Review of Pharmacoeconomics & Outcomes Research·Dyfrig A Hughes
Oct 27, 2006·Pharmacy World & Science : PWS·Mesut SancarGul Dulger

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