Cost-effectiveness of eradication of Helicobacter pylori in gastric cancer survivors after endoscopic resection of early gastric cancer.
BACKGROUND
Clinical effectiveness of Helicobacter pylori eradication in gastric cancer survivors after endoscopic resection of early gastric cancer (EGC) was recently established in a randomized controlled trial. We aimed to establish long-term cost-effectiveness in gastric cancer survivors after endoscopic resection of EGC.


METHODS
A Markov model was constructed to compare the costs and outcomes of the two intervention strategies: (1) eradicate H. pylori after complete resection of EGC by endoscopy (2) do not eradicate. Estimates for variables in the model were obtained by extensive review of published reports. Analyses were made from the Korean public healthcare provider's perspective.


RESULTS
Base-case analysis indicated H. pylori eradication costs less (US$ 29,780 vs. US$ 30,594) than no eradication, and save more lives (mean life expectancy from eradication: 13.60 years vs. 13.55 years). One-way and three-way sensitivity analyses showed the robustness of the cost-effectiveness results.


CONCLUSIONS
In this selective population with very high risk of developing gastric cancer, H. pylori eradication should be considered for reimbursement with priority to prevent subsequent cancer and also reduce health care cost.
Shin
Dong Wook
DW
National Cancer Control Research Institute & Hospital, National Cancer Center, Goyang, Korea.
Yun
Young Ho
YH
Choi
Il Ju
IJ
Koh
Eurah
E
Park
Sang Min
SM
D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics; D004724:Endoscopy; D005260:Female; D017048:Health Care Costs; D016481:Helicobacter Infections / Q000175:diagnosis / Q000191:economics* / Q000382:microbiology / Q000601:surgery; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000382:microbiology / Q000601:surgery; D017741:Survivors; D016896:Treatment Outcome