본문 바로가기
KERD
논문KCI 등재

Cost Effectiveness Associated with Helicobacter pylori Screening and Eradication in Patients Taking Nonsteroidal Anti-Inflammatory Drugs and/or Aspirin

0

조회

0

다운로드

5

인용

0

참고문헌

키워드

초록

Background/Aims: This study was performed to investigate the cost effectiveness of Helicobacter pylori screening/eradication in South Korean patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and/or aspirin. Methods:A decision Markov model was used to estimate the effectiveness and economic impact of an H. pylori screening/eradication strategy compared to a no-screening strategy among patients who were included in the model at the age of 40 years. Utility weights were applied to four of the health status groups to reflect quality-adjusted life years (QALY). The costs of screening, H. pylori eradication, and managing peptic ulcer and ulcer complications were obtained from South Korea-specific data. Results: The total costs per patient were US $2,454 for the H. pylori screening/eradication and US $3,182 for the no-screening strategy. The QALYs for the two strategies were 16.05 and 15.73, respectively. The results were robust for the analyses of all different cohort groups who entered the model at the age of 30, 50, or 60 years and for NSAIDs-naïve patients. Through the probabilistic sensitivity analysis, the robustness of our study’s results was also determined. Conclusions: The H. pylori screening/eradication strategy was found to be less expensive and more effective compared to the no-screening strategy among South Korean patients taking NSAIDs and/or aspirin.

Abstract

Background/Aims: This study was performed to investigate the cost effectiveness of Helicobacter pylori screening/eradication in South Korean patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and/or aspirin. Methods:A decision Markov model was used to estimate the effectiveness and economic impact of an H. pylori screening/eradication strategy compared to a no-screening strategy among patients who were included in the model at the age of 40 years. Utility weights were applied to four of the health status groups to reflect quality-adjusted life years (QALY). The costs of screening, H. pylori eradication, and managing peptic ulcer and ulcer complications were obtained from South Korea-specific data. Results: The total costs per patient were US $2,454 for the H. pylori screening/eradication and US $3,182 for the no-screening strategy. The QALYs for the two strategies were 16.05 and 15.73, respectively. The results were robust for the analyses of all different cohort groups who entered the model at the age of 30, 50, or 60 years and for NSAIDs-naïve patients. Through the probabilistic sensitivity analysis, the robustness of our study’s results was also determined. Conclusions: The H. pylori screening/eradication strategy was found to be less expensive and more effective compared to the no-screening strategy among South Korean patients taking NSAIDs and/or aspirin.

참고문헌 (36)

  1. Graham DY, "Seroepidemiology of Helicobacter pylori infection in India. Comparison of developing and developed countries", Dig Dis Sci, 36, pp.1084~1088 (1991)
  2. "Seroprevalence of Helicobacter pylori in South Korea", HELICOBACTER, 12, pp.333~340 (2007), BLACKWELL PUBLISHING
  3. Sung JJ, "Systematic review: the global incidence and prevalence of peptic ulcer disease", Aliment Pharmacol Ther, 29, pp.938~946 (2009)
  4. "Has peptic ulcer disease changed during the past ten years in Korea? A prospective multi-center study", DIGESTIVE DISEASES AND SCIENCES, 53, pp.1527~1531 (2008), SPRINGER
  5. Leontiadis GI, "Systematic reviews of the clinical effectiveness and cost-effectiveness of proton pump inhibitors in acute upper gastrointestinal bleeding", Health Technol Assess, 11(iii-iv), pp.1~164 (2007)
  6. Lanza FL, "Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications", Am J Gastroenterol, 104, pp.728~738 (2009)
  7. Graham DY, "NSAIDs, risks, and gastroprotective strategies: current status and future", Gastroenterology, 134, pp.1240~1246 (2008)
  8. 이준행, "비스테로이드소염제 관련 소화성궤양의 예방과 치료 가이드라인", 대한소화기학회지, 54(5), pp.309~317 (2009), 대한소화기학회
  9. Lee SW, "Current status of health insurance in the treatment of Helicobacter pylori infection", Hanyang Med Rev, 27, pp.103~106 (2007)
  10. Vergara M, "Meta-analysis: role of Helicobacter pylori eradication in the prevention of peptic ulcer in NSAID users", Aliment Pharmacol Ther, 21, pp.1411~1418 (2005)
  11. Lau JY, "Systematic review of the epidemiology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality", Digestion, 84, pp.102~113 (2011)
  12. 김진주, "2007년도 3차기관에서 진단된 소화성궤양 환자의 임상상", 대한소화기학회지, 59(5), pp.338~346 (2012), 대한소화기학회[DOI]
  13. "Complete Life Table 2009" (1996)[URL]
  14. 김나영, "헬리코박터 파일로리 감염의 진단 및 치료 가이드라인", 대한소화기학회지, 54(5), pp.269~278 (2009), 대한소화기학회
  15. Korean Ministry of Health and Welfare Affairs, "Korean national health and nutritional examination survey (2007-2009)" (2010), Korean Ministry of Health and Welfare Affairs
  16. Latimer N, "Cost effectiveness of COX 2 selective inhibitors and traditional NSAIDs alone or in combination with a proton pump inhibitor for people with osteoarthritis", BMJ, 339, pp.b2538~ (2009)
  17. dental service fee, "Medical", pp.2011, Health Insurance Review and Assessment
  18. Health Insurance Review and Assessment, "Weighted average price by active ingredient of pharmaceutical product" (2010), Health Insurance Review and Assessment
  19. Kim N, "The incidence and direct medical costs of peptic ulcer disease in Korean tertiary medical center" (2009), Health Insurance Review and Assessment
  20. You JH, "Helicobacter pylori eradication prior to initiation of long-term non-steroidal anti-inflammatory drug therapy in Chinese patients-a cost-effectiveness analysis", Int J Clin Pharmacol Ther, 44, pp.149~153 (2006)
  21. Scheiman JM, "Helicobacter pylori screening for individuals requiring chronic NSAID therapy: a decision analysis", Aliment Pharmacol Ther, 15, pp.63~71 (2001)
  22. Leong RW, "Differences in peptic ulcer between the East and the West", Gastroenterol Clin North Am, 38, pp.363~379 (2009)
  23. Feinstein LB, "Trends in hospitalizations for peptic ulcer disease, United States, 1998-2005", Emerg Infect Dis, 16, pp.1410~1418 (2010)
  24. Dong WG, "Epidemiology of peptic ulcer disease in Wuhan area of China from 1997 to 2002", World J Gastroenterol, 10, pp.3377~3379 (2004)
  25. Drummond MF, "Comparing cost-effectiveness across countries: the model of acid-related disease", Pharmacoeconomics, 5, pp.60~67 (1994)
  26. Chan FK, "Randomised trial of eradication of Helicobacter pylori before non-steroidal anti-inflammatory drug therapy to prevent peptic ulcers", Lancet, 350, pp.975~979 (1997)
  27. Chan FK, "Eradication of Helicobacter pylori and risk of peptic ulcers in patients starting long-term treatment with non-steroidal anti-inflammatory drugs: a randomised trial", Lancet, 359, pp.9~13 (2002)
  28. Labenz J, "Primary prevention of diclofenac associated ulcers and dyspepsia by omeprazole or triple therapy in Helicobacter pylori positive patients: a randomised, double blind, placebo controlled, clinical trial", Gut, 51, pp.329~335 (2002)
  29. Go MF, "Review article : natural history and epidemiology of Helicobacter pylori infection", Aliment Pharmacol Ther, (16 Suppl 1), pp.3~15 (2002)
  30. NIH Consensus conference, "Helicobacter pylori in peptic ulcer disease", NIH consensus development panel on Helicobacter pylori in peptic ulcer disease. JAMA, 272, pp.65~69 (1994)
  31. Kurata JH, "Meta-analysis of risk factors for peptic ulcer. Nonsteroidal antiinflammatory drugs, Helicobacter pylori, and smoking", J Clin Gastroenterol, 24, pp.2~17 (1997)
  32. Hunt RH, "Review article: should NSAID", low-dose aspirin takers be tested routinely for H. pylori infection and treated if positive? Implications for primary risk of ulcer and ulcer relapse after initial healing, 2004, pp.1(19 Suppl 1), 9~16
  33. Adamsson I, "Comparative effects of omeprazole, amoxycillin plus metronidazole versus omeprazole, clarithromycin plus metronidazole on the oral, gastric and intestinal microflora in Helicobacter pylori-infected patients", J Antimicrob Chemother, 44, pp.629~640 (1999)
  34. de Boer WA, "The best therapy for Helicobacter pylori infection: should efficacy or side-effect profile determine our choice?", Scand J Gastroenterol, 30, pp.401~407 (1995)
  35. Tong JL, "Meta-analysis: the effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy", Aliment Pharmacol Ther, 25, pp.155~168 (2007)
  36. Joish VN, "The economic impact of GERD and PUD: examination of direct and indirect costs using a large integrated employer claims database", Curr Med Res Opin, 21, pp.535~544 (2005)

관련 논문AI추천

An Economic Modeling Study of Helicobacter pylori Eradication: Comparison of Dual Priming Oligonucleotide-Based Multiplex Polymerase Chain Reaction and Empirical TreatmentByung-Wook Kim, Joon Sung Kim, Tae-Geun Gweon거트앤리버 소화기연관학회협의회 · Gut and Liver2018 · 제12권 제6호Management of Helicobacter pylori Infection: A Comparison between Korea and the United StatesHwang Joo Ha, Kim Sung Eun거트앤리버 소화기연관학회협의회 · Gut and Liver2022 · 제16권 제4호Helicobacter pylori Eradication within 120 Days Is Associated with Decreased Complicated Recurrent Peptic Ulcers in Peptic Ulcer Bleeding PatientsHsiao-Yun Hu, Shen Shong Chang거트앤리버 소화기연관학회협의회 · Gut and Liver2015 · 제9권 제3호Does Helicobacter pylori Exacerbate Gastric Mucosal Injury in Users of Nonsteroidal Anti-Inflammatory Drugs? A Multicenter, Retrospective, Case-Control StudyHiromitsu Kanzaki, Hiroyuki Okada, Kazuhide Yamamoto, Keisuke Hori, Ko Miura, Masahide Kita, Ryuta Takenaka, Seiji Kawano, Takao Tsuzuki, Yoshiro Kawahara, Yoshiyasu Kono거트앤리버 소화기연관학회협의회 · Gut and Liver2016 · 제10권 제1호Evidence based guidelines for the treatment of Helicobacter pylori infection in Korea 2020김지현, 이용찬, 임현철, Cheol Min Shin, Hye-Kyung Jung, Hyo-Joon Yang, Il Ju Choi, Jae Gyu Kim, Jae Myung Park, Miyoung Choi, Seon-Young Park, Seung Joo Kang, Sung Eun Kim, Su Youn Nam, Woon Geon Shin대한내과학회 · The Korean Journal of Internal Medicine2021 · 제36권 제4호Sequential Therapy for Helicobacter pylori Infection in Korea: Systematic Review and Meta-Analysis최황, 김병욱, 김윤경, 김준성, 이민영, 이보인, 지정선, 함주호거트앤리버 소화기연관학회협의회 · Gut and Liver2013 · 제7권 제5호

이 간행물의 다른 논문 (19건)