Griffiths RI, Rabeneck L, Guzman G, Cromwell DM, Strauss MJ, Robinson JW, Winston B, Li T, Graham DY; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1998; 14: 34.

Covance Health Economics and Outcomes Services Inc., Washington, DC, USA.

H. pylori (Hp)-infected ulcer patients are usually treated with antimicrobial and antisecretory therapy to decrease ulcer recurrence. However, the subsequent management of these patients has not been addressed. OBJECTIVE: This study evaluated outcomes and costs of alternative approaches to managing Hp-infected ulcer patients following initial therapy. METHOD: A decision model was used to compare several alternative among Hp-infected ulcer patients following initial therapy: (1) in asymptomatic patients-urease breath testing (UBT) to detect Hp versus observation without further testing; and (2) in symptomatic patients-UBT versus endoscopy with biopsy to detect Hp versus repeat therapy without further testing. The rate of symptomatic ulcer and third party payor costs were assessed at 1 year. RESULTS: Among those asymptomatic following initial therapy, 1.8% of UBT patients had a symptomatic ulcer at 1 year, compared with 9.5% of those with no further testing. The costs were $223 for no further testing and $666 for UBT. Among patients symptomatic following initial therapy, 7.0% of those who received repeat antimicrobial and antisecretory therapy without further testing had a symptomatic ulcer at 1 year, compared with 9.4% of those who had endoscopy with biopsy, and 10% of those who had a UBT. The corresponding costs were $1,015, $2,082, and $1416 respectively. CONCLUSIONS: For Hp-infected ulcer patients who were asymptomatic following intial therapy, UBT resulted in a lower rate of symptomatic ulcers but higher cost compared with observation alone. For patients who were symptomatic following initial therapy, repeat antimicrobial and antisecretory therapy was the most effective and least costly approach.

Publication Types:

• Meeting Abstracts

Keywords:

• Anti-Ulcer Agents
• Biopsy
• Costs and Cost Analysis
• Drug Therapy, Combination
• Duodenal Ulcer
• Helicobacter pylori
• Humans
• Peptic Ulcer
• Recurrence
• Ulcer
• Urease
• drug therapy
• economics
• methods
• therapy
• hsrmtgs

Other ID:

• HTX/98619940

UI: 102234504

From Meeting Abstracts