title: Economic evaluation of test-and-treat and empirical treatment strategies in the eradication of Helicobacter pylori infection; A Markov model in an Iranian adult population.
abstract: BACKGROUND
  Helicobacter pylori may cause many gastrointestinal problems in developing countries such as Iran. We aimed to analyze the cost- effectiveness and cost- utility of the test-and-treat and empirical treatment strategies in managing Helicobacter pylori infection.
  
  
  METHODS
  This was a Markov based economic evaluation. Effectiveness was defined as the symptoms free numbers and QALYs in 100,000 hypothetical adults. The sensitivity analysis was based on Monte Carlo approach.
  
  
  RESULTS
  In the test- and- treat strategy, if the serology is the first diagnostic test vs. histology, the cost per symptoms free number would be 291,736.1 Rials while the cost per QALYs would be 339,226.1 Rials. The cost per symptoms free number and cost per QALYs when the 13 C-UBT was used as the first diagnostic test vs. serology was 1,283,200 and 1,492,103 Rials, respectively. In the empirical strategy, if histology is used as the first diagnostic test vs. 13 CUBT, the cost per symptoms free numbers and cost per QALYs would be 793,234 and 955,698 Rials, respectively. If serology were used as the first diagnostic test vs. histology, the cost per symptoms free and QALYs would be 793,234 and 368941 Rials, respectively.
  
  
  CONCLUSIONS
  There was no significant and considerable dominancy between the alternatives and the diagnostic tests.
authors.affiliation: MA in Public Administration, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran. mazdakii@yahoo.com.
authors.forename: Alireza
authors.initials: A
authors.lastname: Mazdaki
authors.affiliation: PhD Candidate of Health Economics, Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical, Kerman, Iran. hesambs82@gmail.com.
authors.forename: Hesam
authors.initials: H
authors.lastname: Ghiasvand
authors.affiliation: MA in Public Administration, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran. sarabi.a@iums.ac.ir.
authors.forename: Ali
authors.initials: A
authors.lastname: Sarabi Asiabar
authors.affiliation: MSc in Health Economics, Research Center for Social Determinants of Health, Institute for Futures Studies in Health, Kerman University, Kerman, Iran. seyran.naghdi@gmail.com.
authors.forename: Seyran
authors.initials: S
authors.lastname: Naghdi
authors.affiliation: Associate Professor, Department of Health Services Management, School of Health Management and Information Sciences, & Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran. aryankhesal.a@iums.ac.ir.
authors.forename: Aidin
authors.initials: A
authors.lastname: Aryankhesal
keywords: Cost- Effectiveness Analysis; Cost- Utility Analysis; Gastric Acid Anti-Secretory Treatment; Helicobacter Pylori Infection