PGI6: COST-EFFECTIVENESS ANALYSIS OF HELICOBACTER PYLORI ERADICATION TRIPLE THERAPY VERSUS CONVENTIONAL THERAPY FOR GASTRIC AND DUODENAL ULCERS IN JAPAN

Abstract

OBJECTIVES: Helicobacter pylori (H.pylori) eradication triple therapy with a combination of lansoprazole, amoxicillin, and clarithromycin was approved in September 2000 in Japan. The objective of this analysis was to compare the cost-effectiveness of this eradication therapy with conventional H2RA therapy in Japan. METHODS: We used decision analysis software to establish two Markov models, one for gastric ulcers and the other for duodenal ulcers. The model design was based on the Japanese H. pylori eradication guideline and specialists opinions. The model input data were derived mainly from a literature review. The models predict the direct medical costs, number of disease free days (DFDs) and cost per DFD for five years. Sensitivity analyses were conducted by varying the success rate and the probability of endoscopic relapse in symptomatic patients. The payer's perspective was selected. RESULTS: According to the gastric ulcer model, the expected total costs of eradication and conventional therapies for an individual patient at the end of five years would be 169,719 Yen and 390,921 Yen, respectively; the expected DFDs 1,454 days and 1,313 days, respectively; and the expected cost per DFD 117 Yen and 298 Yen, respectively. According to the duodenal ulcer model, the expected total costs of the eradication and conventional therapies would be 134,786 Yen and 324,689 Yen, respectively; the expected DFDs 1,503 days and 1,387 days, respectively; and the expected cost per DFD 90 Yen and 234 Yen, respectively. The sensitivity analyses showed the results of baseline analysis to be robust. CONCLUSIONS: We found that 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. Thus, eradication therapy is recommended for gastric and duodenal ulcers from an economic as well as a clinical viewpoint, in Japan.