Helicobacter pylori "Test-and-Treat" strategy with urea breath test: A cost-effective strategy for the management of dyspepsia and the prevention of ulcer and gastric cancer in Spain-Results of the Hp-Breath initiative

Beresniak, Ariel; Malfertheiner, Peter; Franceschi, Francesco; Liebaert, Francois; Salhi, Hocine und Gisbert, Javier P. (2020): Helicobacter pylori "Test-and-Treat" strategy with urea breath test: A cost-effective strategy for the management of dyspepsia and the prevention of ulcer and gastric cancer in Spain-Results of the Hp-Breath initiative. In: Helicobacter, Bd. 25, Nr. 4, e12693

Abstract

Background: Data from clinical trials comparing Helicobacter pylori (H. pylori) management strategies in patients with dyspepsia are limited. Cost-effectiveness simulation models might help to identify the optimal strategy. Objective: To assess the cost-effectiveness of the H. pylori "Test and Treat" (T&T) strategy including the use of urea breath test (UBT) vs symptomatic treatment (ST) and vs upper gastrointestinal endoscopy (UGE) as a first procedure in patients with dyspepsia. Methods Three main strategies: "T&T" strategy including the use of UBT, "UGE" and "ST" have been compared using cost-effectiveness models developed in accordance with the Spanish medical practice. For the model simulations, a time horizon of 4 weeks was considered for the endpoint "Dyspepsia symptoms relief" and 10 years when using "Peptic ulcer avoided" and "Gastric cancer avoided" endpoints. Results For the endpoint "Dyspepsia symptoms relief", T&T strategy appears to be the most cost-effective (883euro/success) compared to UGE strategy and to ST strategy (respectively 1628euro and 990euro/success). For the endpoint "Probability of peptic ulcer", the T&T strategy appears to be the most cost-effective (421euro/peptic ulcer avoided/y) compared to UGE strategy and ST strategy (respectively 728euro and 632euro/peptic ulcer avoided/y). For the endpoint "Gastric cancer avoided", the T&T strategy appears to be the most cost-effective (524euro/gastric cancer avoided/y) compared to UGE strategy and "ST" strategy (respectively 716euro and 696euro/gastric cancer avoided/y). Conclusions: T&T strategy including the use of UBT is the most cost-effective medical approach for management of dyspepsia and for the prevention of ulcer and gastric cancer.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1083-4389
• Sprache: Englisch