J.M. Mason
Helicobacter pylori eradication in long-term proton pump inhibitor users is highly cost effective: economic analysis of the HELPUP trial
Mason, J.M.; Raghunath, A.S.; Hungin, A.P.; Jackson, W.
Authors
A.S. Raghunath
A.P. Hungin
W. Jackson
Abstract
Background Proton pump inhibitor (PPI) use is costly and about two-thirds of prescribing is long-term. Although 20–50% of patients may be infected with Helicobacter pylori, eradication is not normal clinical practice. Aim To establish if H. pylori eradication in long-term PPI users is cost-effective. Methods Long-term PPI-using patients (n = 183) testing positive for H. pylori were randomly assigned to true or placebo eradication therapy. Patients provided 2-year resource data, and 1-year symptom severity scores. A within-trial cost effectiveness analysis was conducted from a British health service perspective. Results Significant reductions in resource use occurred comparing eradication with placebo. After 2 years, PPI prescriptions (full-dose equivalents) fell by 3.9 (P < 0.0001); clinician (GP) consultations by 2.4 (P = 0.0001); upper gastrointestinal (GI) endoscopies by 14.8% (P = 0.008); clinician GI-related home visits by 19.9% (P = 0.005) and abdominal ultrasound scans fell by 20.3% (P = 0.005). Average net savings/patient were £93 (95% CI: 33–153) after costs of detection and eradication had been deducted. At 1 year, Leeds Dyspepsia Questionnaire symptoms fell by 3.1 (P = 0.005) and quality-of-life measures improved (EuroQol-5D: 0.089, P = 0.08; visual analogue scale: 5.6, P = 0.002) favouring eradication. Conclusion Helicobacter pylori eradication in infected, long-term PPI users is an economically dominant strategy, significantly reducing overall healthcare costs and symptom severity.
Citation
Mason, J., Raghunath, A., Hungin, A., & Jackson, W. (2008). Helicobacter pylori eradication in long-term proton pump inhibitor users is highly cost effective: economic analysis of the HELPUP trial. Alimentary Pharmacology and Therapeutics, 28(11-12), 1297-1303. https://doi.org/10.1111/j.1365-2036.2008.03851.x
Journal Article Type | Article |
---|---|
Publication Date | Dec 1, 2008 |
Deposit Date | Apr 27, 2009 |
Journal | Alimentary Pharmacology and Therapeutics |
Print ISSN | 0269-2813 |
Electronic ISSN | 1365-2036 |
Publisher | Wiley |
Peer Reviewed | Peer Reviewed |
Volume | 28 |
Issue | 11-12 |
Pages | 1297-1303 |
DOI | https://doi.org/10.1111/j.1365-2036.2008.03851.x |
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