[Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases].
Ter Arkh
; 86(8): 56-61, 2014.
Article
em Ru
| MEDLINE
| ID: mdl-25306745
ABSTRACT
AIM:
To estimate the pharmacoeconomic parameters of treatment in patients with Helicobacter pylori-associated diseases when using 6 eradication therapy (ET) regimens. SUBJECTS ANDMETHODS:
The investigation enrolled a total of 231 patients who received anti-Helicobacter pylori therapy according to the intention-to-treat (ITT) principle, including 229 patients who met the protocol requirements, i.e. who completed the prescribed per-protocol (PP) treatment 106 patients with duodenal bulb ulcer disease, 2 with gastric ulcer, 90 with erosive gastritis, and 31 patients with non-atrophic gastritis. In an outpatient setting, the patients received one of the 6 ET regimens OAC, RBMA, RBCA, EBCA, sequential OACM therapy, and modified sequential OACMB therapy (O--omeprazole; A--amoxicillin; C--clarithromycin; B--bismuth tripotassium dicitrate, R--rabeprazole; M--metronidazole; E--esomeprazole). Treatment costs were calculated only from direct drug expenditures. The effective cost coefficient (K(eff)) was determined from the cost/ treatment efficiency ratio K(eff) = cos/eff, where the cost was the average total costs; the eff was efficiency (%).RESULTS:
The modified sequential OACMB therapy has proven to be more cost-efficient than the other regimens as it has a lower K(eff), (14). The RBMA regimens can overcome an 80% ET barrier (82.4%); however, in this case the K(eff) is 21.5. the sequential OACM therapy can also overcome an 80% ET barrier (84.8%); the K(eff) being 10.8. Incorporation of the bismuth preparation can achieve a more noticeable therapeutic effect up to 95.4%. The EBCA regimen has turned out to be most expensive with the highest K(eff) of 36.9. The RBCA regimen is most effective with the least K(eff) of 29; the therapeutic effect is 96.7%.CONCLUSION:
The clinical cost-efficiency of ET is enhanced by the incorporation of the bismuth preparation for the treatment of patients with H. pylori-associated diseases. The modified sequential OACMB therapy can overcome resistance to clarithromycin and metronidazole with a good cost-efficiency.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Úlcera Péptica
/
Honorários por Prescrição de Medicamentos
/
Custos Diretos de Serviços
/
Helicobacter pylori
/
Infecções por Helicobacter
Tipo de estudo:
Guideline
/
Health_economic_evaluation
/
Risk_factors_studies
Limite:
Humans
Idioma:
Ru
Revista:
Ter Arkh
Ano de publicação:
2014
Tipo de documento:
Article