We sought to model the cost-effectiveness of endoscopy, noninvasive testing and treatment strategies for Helicobacter pylori infection in children with recurrent abdominal pain in two health care systems, those of the United States and Finland.
Initial serological testing and treatment was compared to empirical treatment with antimicrobials, endoscopy with rapid urease testing, and 13C urea breath testing.
Key assumptions and ranges were obtained from the published literature.
Costs were determined for the acquisition of various tests and actual reimbursement figures were used for procedural costs.
The disease management costs were very similar for both endoscopy ($643.00) and serology ($646.00) in the United States.
In Finland, endoscopy ($173.00) was less expensive than serology ($192.00).
The 13C urea breath test was the most expensive procedure in the United States.
Sensitivity analysis demonstrated that serological testing became the preferred path if its cost was<$42 in the United States.
Empirical treatment of children with dyspepsia was not cost-effective in either country.
Sensitivity analysis showed that when prevalence of infection was>53% in children with recurrent abdominal pain, empirical therapy with endoscopy reserved for failures was the optimal path.
In developed countries like the United States and Finland, significant cost savings are unlikely with an initial test and treat strategy based on serology. (...)
Mots-clés Pascal : Dyspepsie, Diagnostic, Méthode non invasive, Gastrite, Bactériose, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Stratégie, Traitement, Analyse avantage coût, Enfant, Homme, Appareil digestif pathologie, Estomac pathologie, Economie santé
Mots-clés Pascal anglais : Dyspepsia, Diagnosis, Non invasive method, Gastritis, Bacteriosis, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Strategy, Treatment, Cost benefit analysis, Child, Human, Digestive diseases, Gastric disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0248451
Code Inist : 002B05B02F. Création : 11/09/1998.