Cost-effectiveness comparison of current proton-pump inhibitors to treat gastro-oesophageal reflux disease in the UK
| Autor: | E Remák, R E Brown, C Yuen, A Robinson |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
Cost effectiveness Rabeprazole Lansoprazole Gastroenterology 2-Pyridinylmethylsulfinylbenzimidazoles Esomeprazole Maintenance therapy Internal medicine Medicine Humans Dosing Intensive care medicine Pantoprazole Omeprazole business.industry Proton Pump Inhibitors General Medicine Anti-Ulcer Agents United Kingdom Sulfoxides Gastroesophageal Reflux Benzimidazoles business medicine.drug |
| Zdroj: | Current medical research and opinion. 21(10) |
| ISSN: | 0300-7995 |
| Popis: | Gastro-oesophageal reflux disease (GORD) is a recurring condition with many patients requiring long-term maintenance therapy. Therefore initial choice of treatment has long-term cost implications. The aim was to compare the costs and effectiveness of treatment of GORD the (unconfirmed by endoscopy) with seven proton pump inhibitors (PPIs: esomeprazole, lansoprazole (capsules and oro-dispersible tablets), omeprazole (generic and branded), pantoprazole and rabeprazole), over one year.A treatment model was developed of 13 interconnected Markov models incorporating acute treatment of symptoms, long-term therapy and subsequent decisions to undertake endoscopy to confirm diagnosis. Patients were allowed to stop treatment or to receive maintenance treatment either continuously or on-demand depending on response to therapy. Long-term dosing schedule (high dose or step-down dose) was based on current market data. Efficacy of treatments was based on clinical trials and follow-up studies, while resource use patterns were determined by a panel of physicians.The model predicts total expected annual costs, number of symptom-free days and quality-adjusted life-years (QALY).Generic omeprazole and rabeprazole dominated (i.e. cost less and resulted in more symptom-free days and higher QALY gains) the other PPIs. Rabeprazole had a favourable cost-effectiveness ratio of 3.42 pounds per symptom-free day and 8308 pounds/quality-adjusted life-year gained when compared with generic omeprazole. Rabeprazole remained cost-effective independent of choice of maintenance treatment (i.e. proportion of patients remaining on continuous treatment versus on-demand treatment).Economic models provide a useful framework to evaluate PPIs in realistic clinical scenarios. Our findings show that rabeprazole is cost-effective for the treatment of GORD. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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