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  1. Varying efficacy of Helicobacter pylori eradication regimens : cost effectiveness study using a decision analysis model. Commentary.

    Article - En anglais

    Objective 

    To determine how small differences in the efficacy and cost of two antibiotic regimens to eradicate Helicobacter pylori can affect the overall cost effectiveness of pylori eradication in duodenal ulcer disease.

    Design 

    A decision analysis to examine the cost effectiveness of eight H pylori eradication strategies for duodenal ulcer disease with and without 13C-urea breath testing to confirm eradication.

    Main outcome measures 

    Cumulative direct treatment costs per 100 patients with duodenal ulcer disease who were positive for H pylori.

    Results 

    In model 1 the strategy of omeprazole, clarithromycin, and metronidazole alone was the most cost effective of the four strategies assessed.

    The addition of the 13C-urea breath test and a second course of omeprazole, clarithromycin, and metronidazole achieved the highest eradication rate (97%)) but was the most expensive (£62.63 per patient).

    The cost of each additional effective eradication was £589.00 (incremental cost per case) when compared with the cost of treating once only with omeprazole, clarithromycin, and metronidazole ; equivalent to the cost of patient receiving ranitidine for duodenal ulcer relapse for more than 15 years.

    Eradication strategies of omeprazole, amoxycillin, and metronidazole were less cost effective than omeprazole, darithromycin, and metronidazole alone. (...)

    Mots-clés Pascal : Ulcère, Duodénum, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Modèle, Prise décision, Méthodologie, Chimiothérapie, Traitement, Analyse coût efficacité, Homme, Etude comparative, Economie santé, Epidémiologie, Angleterre, Grande Bretagne, Royaume Uni, Europe, Appareil digestif pathologie, Intestin pathologie

    Mots-clés Pascal anglais : Ulcer, Duodenum, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Models, Decision making, Methodology, Chemotherapy, Treatment, Cost efficiency analysis, Human, Comparative study, Health economy, Epidemiology, England, Great Britain, United Kingdom, Europe, Digestive diseases, Intestinal disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0282193

    Code Inist : 002B13B03. Création : 27/11/1998.