[Medico-economic aspects of the treatment of duodenal ulcer: from antisecretory treatment to eradication of Helicobacter pylori].
OBJECTIVE
Radical changes are currently taking place in the treatment of duodenal ulcer, where strategies of eradication of Helicobacter pylori are replacing traditional antisecretory treatment. The aim of this study is to present the economic aspects of the different therapeutic approaches.


METHODS
A critical analysis based on a selected number of clinical trials and medical economic analyses published in the international literature.


RESULTS
A comparative analysis of traditional ranitidine/omeprazole treatments shows that ranitidine is more cost-effective in France at short term. With regard to traditional strategies, there are no French studies comparing H2-antagonists to proton pump inhibitors. Comparative studies seem in favour of eradication of Helicobacter pylori over traditional therapies, both in terms of cost and effectiveness.


CONCLUSIONS
Arguments comparing the effectiveness of proton pump inhibitors versus H2-antagonists have become obsolete. In current therapeutic approaches of duodenal ulcer, the level of inhibition of the acid secretion no longer plays an important role.
Carrère
M O
MO
CNRS URA 934, Université Lyon 1, Villeurbanne.
Auquier
P
P
Poynard
T
T
Sambuc
R
R
D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000191:economics* / Q000382:microbiology / Q000601:surgery; D016481:Helicobacter Infections / Q000191:economics* / Q000382:microbiology / Q000601:surgery; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D009853:Omeprazole / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors; D016032:Randomized Controlled Trials as Topic; D011899:Ranitidine / Q000627:therapeutic use*
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D011899:Ranitidine; D009853:Omeprazole
Aspects médico-économiques du traitement de l'ulcère duodénal: du traitement antisécrétoire à l'éradication d'Helicobacter pylori.