[Evaluation of the efficacy and the cost-effectiveness of maintenance treatment of gastroesophageal reflux disease: proton pump inhibitor versus histamine-2-receptor antagonist].
GERD is a common condition and acid-suppressing agents are the mainstay of treatment. A cost-effectiveness analysis comparing a PPI, lansoprazole (LPZ) and a H2RA, famotidine (FAM) for the maintenance treatment of reflux esophagitis in Japan was performed using a Markov chain approach. The time period studied was 6 months and payer perspective was chosen. Transition probabilities were estimated from meta-analyses. Expected days without esophagitis (healthy days) were 166 for LPZ 30 mg/day, 161 for LPZ 15 mg/day and 143 for FAM 40 mg/day. Direct costs were 55,624 yen for LPZ 30 mg/day, 42,078 yen for LPZ 15 mg/day and 67,969 yen for FAM 40 mg/day. Cost-effectiveness ratio (direct costs/healthy days) was 335 yen for LPZ 30 mg/day, 262 yen for LPZ 15 mg/day and 477 yen for FAM 40 mg/day. Lansoprazole was superior to famotidine with regard to both efficacy and cost-effectiveness and therefore is the preferred therapeutic agent for the maintenance treatment of GERD.
Habu
Yasuki
Y
Department of Gastroenterology, Saiseikai-Noe Hospital.
Yoshino
Takuya
T
Shio
Seiji
S
Hayakumo
Takanobu
T
Kawai
Keiichi
K
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D001562:Benzimidazoles / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000191:economics / Q000627:therapeutic use*; D015738:Famotidine / Q000191:economics / Q000627:therapeutic use*; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000191:economics; D006635:Histamine H2 Antagonists / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D007564:Japan; D064747:Lansoprazole; D008390:Markov Chains; D015201:Meta-Analysis as Topic; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors; D064750:Rabeprazole; D016032:Randomized Controlled Trials as Topic
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D001562:Benzimidazoles; D004791:Enzyme Inhibitors; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D064750:Rabeprazole; D015738:Famotidine; D009853:Omeprazole