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
Rev. méd. Chile
; 128(4): 367-77, abr. 2000. tab, graf
Article
in Spanish
| LILACS
| ID: lil-263705
Responsible library:
CL1.1
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 andmethods:
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
Full text:
Available
Collection:
International databases
Health context:
Sustainable Health Agenda for the Americas
Health problem:
Goal 4: Health financing
Database:
LILACS
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
Document type:
Article
/
Project document
Affiliation country:
Chile