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Tratamiento de la infección por helicobacter pylori en pacientes con úlcera duodenal: estudio de costo beneficio / Treatment of helicobacter pylori infection in patients with duodenal ulcer: a cost benefit study
Rollán Rodríguez, Antonio; Giancaspero P., Rossana; Acevedo G., Claudia; Fuster S., Francisco; Hola Ch., Karen.
  • Rollán Rodríguez, Antonio; Pontificia Universidad Católica de Chile. Facultad de Medicina. Departamento de Gastroenterología.
  • Giancaspero P., Rossana; s.af
  • Acevedo G., Claudia; s.af
  • Fuster S., Francisco; s.af
  • Hola Ch., Karen; s.af
Rev. méd. Chile ; 128(4): 367-77, abr. 2000. tab, graf
Article in Spanish | LILACS | ID: lil-263705
RESUMEN

Background:

Epidemiological differences suggest that treatments for H. pylori eradication should be locally validated.

Aim:

To perform a cost benefit study of different treatment options for H. pylori infection. Patients and

methods:

One hundred and sixty-seven patients with active duodenal ulcer and H. pylori infection who completed a 2-week treatment with one of the following regimens were included famotidine plus amoxycillin plus metronidazole (FAM), omeprazole plus amoxycillin plus tinidazole (OAT) or lansoprazole plus clarithromycin plus amoxycillin in 3 (LAC1) or 2 (LAC2) daily doses. We compared efficacy, adverse effects and cost.

Results:

Eradication rate was 74.6, 72.9, 96.4 y 91.7 percent for FAM, OAT, LAC1 and LAC2 respectively (p<0.05). Direct cost ranged from US$ 50 for FAM to US$ 220 for LAC1. A decision analysis was carried out in a model including direct and indirect costs and considering retreatment with antibiotics after the first treatment failure and one-year treatment with H2-blockers in case of a second failure. FAM was selected as the most cost-effective option, with an estimated cost of about US$ 300 ñ 148 per patient. However, cost associated to LAC2 was very similar (US$ 320 ñ 58) and the lower standard deviation suggests less variation. Sensitivity analyses, considering reasonable fluctuation in parameters such as eradication rate, cost and follow-up period suggest that a regimen containing a proton pump inhibitor, clarithromycin and amoxycillin may be the most cost-effective treatment.

Conclusions:

These results should be confirmed in other settings, specially in ordinary clinical practice, far from clinical research
Subject(s)
Full text: Available Index: LILACS (Americas) Main subject: Helicobacter pylori / Helicobacter Infections Type of study: Diagnostic study / Health economic evaluation / Observational study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2000 Type: Article / Project document Affiliation country: Chile

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Full text: Available Index: LILACS (Americas) Main subject: Helicobacter pylori / Helicobacter Infections Type of study: Diagnostic study / Health economic evaluation / Observational study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2000 Type: Article / Project document Affiliation country: Chile