Antibiotic therapy of Helicobacter pylori infection reduces healthcare expenditures related to duodenal ulcer.
OBJECTIVE
To test whether eradication of Helicobacter pylori saves costs in the treatment of duodenal ulcer disease, compared with conventional antisecretory therapy.


METHODS
A prospective, double-blind clinical trial was conducted at 132 sites in the United States.


METHODS
Adult patients with active duodenal ulcer and confirmed H pylori infection were randomized to receive treatment with clarithromycin plus omeprazole, omeprazole alone, or ranitidine alone. Utilization of ulcer-related healthcare resources was documented during 1 year following therapy. Costs were calculated by multiplying the number of health resources utilized by the cost of each resource. Resource costs were obtained from a database containing actual average costs spent by managed care organizations on outpatient and inpatient treatment.


RESULTS
Of the 819 patients enrolled, 727 completed the study: 243 received clarithromycin plus omeprazole, 248 omeprazole alone, and 236 ranitidine alone. Ulcer-related health resource utilization and total ulcer-related healthcare costs were decreased after treatment with clarithromycin plus omeprazole, compared to treatment with omeprazole or ranitidine alone. In multivariate linear regression analyses, type of treatment was found to be a significant predictor of total costs. Specific costs associated with endoscopic examinations, clinic visits, and medications were also significantly reduced by treatment with clarithromycin plus omeprazole as compared to other treatment forms.


CONCLUSIONS
In a managed care environment, therapy with clarithromycin and omeprazole to eradicate H pylori in patients with duodenal ulcer disease would result in significant cost savings secondary to a reduction in the utilization of healthcare resources.
Sonnenberg
A
A
Department of Veterans Affairs Medical Center 111F, Albuquerque, NM 87108, USA.
Pauly
M P
MP
Levenson
S D
SD
Schwartz
J S
JS
D000293:Adolescent; D000328:Adult; D000897:Anti-Ulcer Agents / Q000191:economics / Q000627:therapeutic use*; D017291:Clarithromycin / Q000191:economics / Q000627:therapeutic use*; D004311:Double-Blind Method; D016527:Drug Costs / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D004381:Duodenal Ulcer / Q000150:complications / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008329:Managed Care Programs / Q000191:economics*; D009853:Omeprazole / Q000191:economics / Q000627:therapeutic use*; D011446:Prospective Studies; D011899:Ranitidine / Q000191:economics / Q000627:therapeutic use*; D014481:United States
D000897:Anti-Ulcer Agents; D011899:Ranitidine; D017291:Clarithromycin; D009853:Omeprazole