title: Economic analysis of alternative treatments for persistent gastro-oesophageal reflux disease.
abstract: The economic evaluation of new medicines is increasingly important for pricing, registration and selection for use. A decision-analytic strategy was performed to assess the economic impact of antacids alone (phase I therapy), and in combination with either omeprazole, 20 mg once daily, or ranitidine, 150 mg twice daily, for patients with persistent, symptomatic gastro-oesophageal reflux disease of grade II or more (Savary-Miller classification). Data were obtained from published literature, an expert panel of gastroenterologists and actual payments by a private insurer in the USA. Over the 7-month period of the analysis, omeprazole reduced both symptoms and overall costs when compared with ranitidine or antacids. Consequently, the cost per symptom-free month was 43% lower with omeprazole than with ranitidine. Thus, omeprazole should be considered as the initial therapeutic approach for patients in whom phase I therapy fails.
authors.affiliation: Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia 19104-6218.
authors.forename: A L
authors.initials: AL
authors.lastname: Hillman
mesh_terms: D003362:Cost-Benefit Analysis; D003663:Decision Trees; D016527:Drug Costs / Q000706:statistics & numerical data; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D009853:Omeprazole / Q000008:administration & dosage / Q000191:economics*; D011899:Ranitidine / Q000008:administration & dosage / Q000191:economics*; D016896:Treatment Outcome
chemical_list: D011899:Ranitidine; D009853:Omeprazole