Economic evaluation of a randomized trial comparinghelicobacter pylori test-and-treat and prompt endoscopy strategies for managing dyspepsia in a primary-care setting
| Autor: | Nicolaas L. A. Arents, Jacobus R. B. J. Brouwers, Rogier M. Klok, Robin de Vries, Jan H. Kleibeuker, Maarten J. Postma, Jacob C. Thijs |
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| Přispěvatelé: | Groningen University Institute for Drug Exploration (GUIDE), Faculty of Science and Engineering, Faculteit Medische Wetenschappen/UMCG, Methods in Medicines evaluation & Outcomes research (M2O), Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Cost effectiveness Cost-Benefit Analysis dyspepsia COST-EFFECTIVENESS ANALYSIS PERSISTENT DYSPEPSIA THERAPY Helicobacter Infections law.invention Quality of life Randomized controlled trial REFLUX ESOPHAGITIS law Gastroscopy Humans Medicine Pharmacology (medical) Reflux esophagitis cost-effectiveness health care economics and organizations Netherlands Randomized Controlled Trials as Topic Pharmacology Helicobacter pylori DRUG-TREATMENT business.industry OMEPRAZOLE Cost-effectiveness analysis Middle Aged Anti-Ulcer Agents Confidence interval Surgery MANAGEMENT STRATEGIES Economic evaluation Emergency medicine Female DECISION-ANALYSIS FUNCTIONAL DYSPEPSIA PEPTIC-ULCER business Algorithms Health Utilities Index |
| Zdroj: | Clinical Therapeutics, 27(10), 1647-1657. Elsevier |
| ISSN: | 0149-2918 |
| DOI: | 10.1016/j.clinthera.2005.10.011 |
| Popis: | Background: In western European countries, most dyspeptic patients are initially managed by their general practitioners (GPs), who use a range of strategies to manage dyspepsia. We performed an economic analysis of a Helicobacter pylori test-and-treat strategy versus a prompt endoscopy approach in a primary care setting.Methods: Data were used from the Strategy: Endoscopy versus Serology (SENSE) study, performed in The Netherlands from 1998 to 2001. Patients were randomized to a prompt endoscopy (n = 105) or test-and-treat (n = 118) group. Follow-up lasted I year. Adverse events were not recorded in the SENSE study. Health care costs were based on the total amount of dyspepsia-related drugs used, the number of dyspepsia-related GP visits, the number of diagnostic tests, and the number of dyspepsia-related referrals to specialists. The use of medical resources was calculated as standardized costs for 1999, recorded as euros. (On December 31, 1999, Euro1.00 = US $1.00.) Quality of life was measured at inclusion and 1 year later, using the RAND-36 questionnaire. To calculate quality-adjusted life-years (QALYs), we transformed the individual scores of the RAND-36 into I overall score, the Health Utilities Index Mark 2, which introduced a limitation to the study. An incremental cost-effectiveness ratio (ICER) was calculated. The 95% confidence limits were calculated using a parametric bootstrap method with angular transformation. All cost data were analyzed from a third-party payer perspective.Results: The total costs per patient were Euro511, with 0.037 QALY gained per patient, in the test-and-treat group, and Euro748, with 0.032 QALY gained per patient, in the endoscopy group (between groups, P Conclusion: This analysis of data from the SENSE study suggests that the H pylori test-and-treat strategy was more cost-effective than prompt endoscopy in the initial management of dyspepsia in general practice, from the perspective of a third-party payer. |
| Databáze: | OpenAIRE |
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