Efficacy and cost-effectiveness analysis of probiotics in initial Helicobacter pylori eradication therapy / 中华全科医师杂志

ABSTRACT

Objective:To analyze the efficacy and cost-effectiveness of probiotics in initial Helicobacter pylori ( H. pylori) eradication therapy. Methods:A total of 267 patients with positive H. pylori infection were randomly assigned to two groups, the control group ( n=133) received a 14-day bismuth agent quadruple therapy and the study group ( n=144) received conventional quadruple therapy plus probiotics from January 2020 to August 2021. Eradication status was assessed 4-12 weeks after treatment. The H.pylori eradication rate, adverse reactions, and cost-effectiveness were compared between the two groups. Results:The H.pylori eradication rate was higher in study group than that in the control group in intention-to-treat (ITT) (80.6%(108/134), 95% CI73.8%-87.4% vs. 68.4%(91/133), 95% CI60.4%-76.4%, P=0.022) and per-protocol (83.1%(108/130), 95% CI76.5%-89.6% vs. 72.2%(91/126), 95% CI64.3%-80.2%, P=0.037). The incidence of adverse effects in the study group was lower than that in the control group (8.2%(11/134) vs. 18.8%(25/133), χ 2=6.415, P=0.011). Cost-effectiveness analysis showed that compared with the control group, the incremental cost-effectiveness ratio (ICER) of the study group was 1 010.49 yuan. The single factor sensitivity analysis showed that the H.pylori eradication rate of the study group had a greater impact on the results, followed by that of the control group and the cost of bifidobacterium quadruplex viable tablets. The probability sensitivity analysis showed that when the willingness to pay value (WTP) was 2 500 yuan, the probability that the probiotics combined with the bismuth agent quadruple therapy group was more cost-effective than the simple bismuth agent quadruple therapy group was 91.2%. Conclusion:As initial Helicobacter pylori treatment, probiotics combined with the bismuth agent quadruple scheme has a higher eradication rate and a lower incidence of adverse events than the bismuth agent quadruple scheme.