Cost-effectiveness analysis of two management strategies for dyspepsia.
Int J Technol Assess Health Care
; 23(3): 376-84, 2007.
Article
em En
| MEDLINE
| ID: mdl-17579942
ABSTRACT
OBJECTIVES:
To compare the cost-effectiveness of endoscopy and empirical proton pump inhibition (PPI) therapy for management of dyspepsia in primary care.METHODS:
A randomized controlled trial, including prospective collection of economic resource data, was conducted in general practice from June 2000 to August 2002, Aarhus County, Denmark. We randomly assigned 368 dyspeptic patients from thirty-two general practices to treatment with omeprazol 40 mg for 2 weeks (n=184) or endoscopy (n=184). The study adopted a societal perspective, and the year of costing was 2006. OUTCOMEMEASURES:
days free of dyspeptic symptoms and proportion of patients with dyspepsia after 1 year based on patients' and general practitioners' (GPs) assessment. Costs were estimated from patient and GP questionnaires and from medical records.RESULTS:
The incremental cost-effectiveness (CE) ratio for 1 day free of dyspeptic symptoms using the endoscopy strategy was euro/day 154 compared with the PPI strategy. The incremental CE ratio for one person free of dyspeptic symptoms after 1 year using the endoscopy strategy was euro13,905 based on the patients' evaluation, and the incremental CE ratio for one person free of predominant symptoms after 1 year was euro5,990 according to the GPs' evaluation. The PPI strategy was both cheaper and more effective than the endoscopy strategy when reflux was the predominant symptom.CONCLUSIONS:
A strategy using empirical antisecretory PPI therapy should be recommended if the alternative is an endoscopy strategy for managing dyspeptic patients in general practice, especially if reflux was the predominant symptom.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Omeprazol
/
Dispepsia
/
Inibidores da Bomba de Prótons
Tipo de estudo:
Clinical_trials
/
Health_economic_evaluation
/
Observational_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Int J Technol Assess Health Care
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Dinamarca