title: [Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases].
abstract: OBJECTIVE
  To estimate the pharmacoeconomic parameters of treatment in patients with Helicobacter pylori-associated diseases when using 6 eradication therapy (ET) regimens.
  
  
  METHODS
  The investigation enrolled a total of 231 patients who received anti-Helicobacter pylori therapy according to the intention-to-treat (ITT) principle, including 229 patients who met the protocol requirements, i.e. who completed the prescribed per-protocol (PP) treatment: 106 patients with duodenal bulb ulcer disease, 2 with gastric ulcer, 90 with erosive gastritis, and 31 patients with non-atrophic gastritis. In an outpatient setting, the patients received one of the 6 ET regimens: OAC, RBMA, RBCA, EBCA, sequential OACM therapy, and modified sequential OACMB therapy (O--omeprazole; A--amoxicillin; C--clarithromycin; B--bismuth tripotassium dicitrate, R--rabeprazole; M--metronidazole; E--esomeprazole). Treatment costs were calculated only from direct drug expenditures. The effective cost coefficient (K(eff)) was determined from the cost/ treatment efficiency ratio: K(eff) = cos/eff, where the cost was the average total costs; the eff was efficiency (%).
  
  
  RESULTS
  The modified sequential OACMB therapy has proven to be more cost-efficient than the other regimens as it has a lower K(eff), (14). The RBMA regimens can overcome an 80% ET barrier (82.4%); however, in this case the K(eff) is 21.5. the sequential OACM therapy can also overcome an 80% ET barrier (84.8%); the K(eff) being 10.8. Incorporation of the bismuth preparation can achieve a more noticeable therapeutic effect up to 95.4%. The EBCA regimen has turned out to be most expensive with the highest K(eff) of 36.9. The RBCA regimen is most effective with the least K(eff) of 29; the therapeutic effect is 96.7%.
  
  
  CONCLUSIONS
  The clinical cost-efficiency of ET is enhanced by the incorporation of the bismuth preparation for the treatment of patients with H. pylori-associated diseases. The modified sequential OACMB therapy can overcome resistance to clarithromycin and metronidazole with a good cost-efficiency.
authors.forename: A A
authors.initials: AA
authors.lastname: Samsonov
authors.forename: V B
authors.initials: VB
authors.lastname: Grechushnikov
authors.forename: D N
authors.initials: DN
authors.lastname: Andreev
authors.forename: G L
authors.initials: GL
authors.lastname: Iurenev
authors.forename: T I
authors.initials: TI
authors.lastname: Korovina
authors.forename: Iu A
authors.initials: IuA
authors.lastname: Lezhneva
authors.forename: I V
authors.initials: IV
authors.lastname: Maev
mesh_terms: D000863:Antacids / 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; D003362:Cost-Benefit Analysis; D004180:Direct Service Costs; D004359:Drug Therapy, Combination; D017850:Economics, Pharmaceutical; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000191:economics / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000191:economics / Q000382:microbiology; D011306:Prescription Fees; D016896:Treatment Outcome
chemical_list: D000863:Antacids; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents