Costs of diagnosis and treatment of Helicobacter pylori infection : When does choosing the treatment regimen based on susceptibility testing become cost effective ?
Antibiotic-resistant Helicobacter pylori (H. pylori) strains are becoming increasingly prevalent.
Currently, most physicians treat H. pylori infections without relying on antimicrobial susceptibility testing to choose the best regimen.
This study was conducted to evaluate whether routine pretreatment susceptibility testing is cost effective from a third party payer point of view.
A decision model was devised to compare direct costs and outcome for diagnosis and treatment over I year for two different strategies.
Strategy A : Endoscopy plus biopsy followed by an empirical antibiotic treatment of H. pylori-positive ulcer patients.
Treatment failure was followed by reendoscopy with biopsy and antibiotic susceptibility testing and a second treatment.
Strategy B : Endoscopy as in strategy A now followed by antibiotic susceptibility testing and tailored antibiotic treatment.
Treatment failure was handled as in strategy A. RESULTS : Following through with strategy A or B, the overall cure rate for both strategies was virtually identical.
Therefore, cost effectiveness is defined as money saved per patient by using strategy B, while achieving similar effectiveness (cure rates).
As an example we compared therapies for a population with known parameters for antibiotic resistance as well as cure rates.
Pretreatment susceptibility testing would save $37,000 per 1,000 patients treated. (...)
Mots-clés Pascal : Gastrite, Bactériose, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Coût, Diagnostic, Traitement, Critère sélection, Résistance traitement, Analyse décision, Analyse avantage coût, Homme, Appareil digestif pathologie, Estomac pathologie, Economie santé
Mots-clés Pascal anglais : Gastritis, Bacteriosis, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Costs, Diagnosis, Treatment, Selection criterion, Negative therapeutic reaction, Decision analysis, Cost benefit analysis, Human, Digestive diseases, Gastric disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0181241
Code Inist : 002B30A01C. Création : 16/11/1999.