Evaluation of the cost-effectiveness of Helicobacter pylori eradication triple therapy vs. conventional therapy for ulcers in Japan.
BACKGROUND
Helicobacter pylori eradication triple therapy with a combination of lansoprazole, amoxicillin and clarithromycin was approved in Japan in September 2000.


OBJECTIVE
To compare the cost-effectiveness of this eradication therapy with conventional histamine-2 receptor antagonist therapy in Japan.


METHODS
We established two Markov models for gastric and duodenal ulcers. The model design was based on the Japanese H. pylori eradication guideline and a specialist's opinions, and the model inputs were obtained from a literature review. The models predict the direct medical costs, number of disease-free days and cost per disease-free day for 5 years.


RESULTS
In the gastric ulcer model, the expected total costs of eradication and conventional therapies per patient were yen169 719 and yen390 921, respectively; the expected numbers of disease-free days were 1454 days and 1313 days, respectively. In the duodenal ulcer model, the expected total costs were yen134 786 and yen324 689, respectively; the expected numbers of disease-free days were 1503 days and 1387 days, respectively. The sensitivity analyses showed that the results of the base case analysis were robust.


CONCLUSIONS
This eradication therapy is less costly and more effective than conventional therapy for the treatment of gastric and duodenal ulcers in a Japanese medical setting.
Ikeda
S
S
Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan. shunya@post.harvard.edu
Tamamuro
T
T
Hamashima
C
C
Asaka
M
M
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000658:Amoxicillin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D017291:Clarithromycin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000191:economics; D017048:Health Care Costs / Q000706:statistics & numerical data*; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000191:economics*; D006801:Humans; D064747:Lansoprazole; D008390:Markov Chains; D009853:Omeprazole / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use*; D010406:Penicillins / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D013276:Stomach Ulcer / Q000188:drug therapy / Q000191:economics; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D010406:Penicillins; D064747:Lansoprazole; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole