Economic evaluation of empirical antisecretory therapy versus Helicobacter pylori for management of dyspepsia: A randomized trial in primary care
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Economic evaluation of empirical antisecretory therapy versus Helicobacter pylori for management of dyspepsia : A randomized trial in primary care. / Jarbol, Dorte Ejg; Bech, Mickael; Kragstrup, Jakob; Havelund, Troels; De Muckadell, Ove B.Schaffalitzky.
In: International Journal of Technology Assessment in Health Care, Vol. 22, No. 3, 07.2006, p. 362-371.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Economic evaluation of empirical antisecretory therapy versus Helicobacter pylori for management of dyspepsia
T2 - A randomized trial in primary care
AU - Jarbol, Dorte Ejg
AU - Bech, Mickael
AU - Kragstrup, Jakob
AU - Havelund, Troels
AU - De Muckadell, Ove B.Schaffalitzky
PY - 2006/7
Y1 - 2006/7
N2 - Objectives: An economic evaluation was performed of empirical antisecretory therapy versus test for Helicobacter pylori in the management of dyspepsia patients presenting in primary care. Methods: A randomized trial in 106 general practices in the County of Funen, Denmark, was designed to include prospective collection of clinical outcome measures and resource utilization data. Dyspepsia patients (n=722) presenting in general practice with more than 2 weeks of epigastric pain or discomfort were managed according to one of three initial management strategies: (i) empirical antisecretory therapy, (ii) testing for Helicobacter pylori, or (iii) empirical antisecretory therapy, followed by Helicobacter pylori testing if symptoms improved. Cost-effectiveness and incremental cost-effectiveness ratios of the strategies were determined. Results: The mean proportion of days without dyspeptic symptoms during the 1-year follow-up was 0.59 in the group treated with empirical antisecretory therapy, 0.57 in the H. pylori test-and-eradicate group, and 0.53 in the combination group. After 1 year, 23 percent, 26 percent, and 22 percent, respectively, were symptom-free. Applying the proportion of days without dyspeptic symptoms, the cost-effectiveness for empirical treatment, H. pylori test and the combination were 12,131 Danish kroner (DKK), 9,576 DKK, and 7,301 DKK, respectively. The incremental cost-effectiveness going from the combination strategy to empirical antisecretory treatment or H. pylori test alone was 54,783 DKK and 39,700 DKK per additional proportion of days without dyspeptic symptoms. Conclusions: Empirical antisecretory therapy confers a small insignificant benefit but costs more than strategies based on test for H. pylori and is probably not a cost-effective strategy for the management of dyspepsia in primary care.
AB - Objectives: An economic evaluation was performed of empirical antisecretory therapy versus test for Helicobacter pylori in the management of dyspepsia patients presenting in primary care. Methods: A randomized trial in 106 general practices in the County of Funen, Denmark, was designed to include prospective collection of clinical outcome measures and resource utilization data. Dyspepsia patients (n=722) presenting in general practice with more than 2 weeks of epigastric pain or discomfort were managed according to one of three initial management strategies: (i) empirical antisecretory therapy, (ii) testing for Helicobacter pylori, or (iii) empirical antisecretory therapy, followed by Helicobacter pylori testing if symptoms improved. Cost-effectiveness and incremental cost-effectiveness ratios of the strategies were determined. Results: The mean proportion of days without dyspeptic symptoms during the 1-year follow-up was 0.59 in the group treated with empirical antisecretory therapy, 0.57 in the H. pylori test-and-eradicate group, and 0.53 in the combination group. After 1 year, 23 percent, 26 percent, and 22 percent, respectively, were symptom-free. Applying the proportion of days without dyspeptic symptoms, the cost-effectiveness for empirical treatment, H. pylori test and the combination were 12,131 Danish kroner (DKK), 9,576 DKK, and 7,301 DKK, respectively. The incremental cost-effectiveness going from the combination strategy to empirical antisecretory treatment or H. pylori test alone was 54,783 DKK and 39,700 DKK per additional proportion of days without dyspeptic symptoms. Conclusions: Empirical antisecretory therapy confers a small insignificant benefit but costs more than strategies based on test for H. pylori and is probably not a cost-effective strategy for the management of dyspepsia in primary care.
KW - Antiulcer agents
KW - Dyspepsia
KW - Healthcare costs
KW - Helicobacter pylori
KW - Primary health care
UR - http://www.scopus.com/inward/record.url?scp=33749119997&partnerID=8YFLogxK
U2 - 10.1017/S0266462306051269
DO - 10.1017/S0266462306051269
M3 - Journal article
C2 - 16984065
AN - SCOPUS:33749119997
VL - 22
SP - 362
EP - 371
JO - International Journal of Technology Assessment in Health Care
JF - International Journal of Technology Assessment in Health Care
SN - 0266-4623
IS - 3
ER -
ID: 324141179