Treatment strategies for reflux esophagitis including a potassium‐competitive acid blocker: A cost‐effectiveness analysis in Japan
| Autor: | Motonobu Maruo, Ryuhei Hamasaki, Yasuki Habu, Yuki Aono, Tatsuya Nakagawa, Daisaku Hachimine |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
medicine.medical_specialty vonoprazan proton pump inhibitor medicine.drug_class Cost effectiveness Vonoprazan gastroesophageal reflux disease Lansoprazole Proton-pump inhibitor reflux esophagitis R5-920 Internal Medicine medicine Reflux esophagitis Intensive care medicine business.industry fungi Reflux food and beverages Original Articles cost‐effectiveness potassium‐competitive acid blocker Cost-effectiveness analysis Treatment strategy Original Article Geriatrics and Gerontology Family Practice business medicine.drug |
| Zdroj: | Journal of General and Family Medicine, Vol 22, Iss 5, Pp 237-245 (2021) Journal of General and Family Medicine |
| ISSN: | 2189-7948 |
| DOI: | 10.1002/jgf2.429 |
| Popis: | Introduction Gastroesophageal reflux disease is a common condition, and proton pump inhibitors (PPIs) are the mainstays of treatment. However, concerns have been raised about the safety of PPIs. A potassium‐competitive acid blocker (P‐CAB), vonoprazan (VPZ), was recently introduced, which may provide clinical benefits. This study was performed to investigate the cost‐effectiveness of alternative long‐term strategies including continuous and discontinuous treatment with VPZ for the management of reflux esophagitis in Japan. Methods A health state transition model was developed to capture the long‐term management of reflux esophagitis. Four different strategies were compared: (a) intermittent PPI using lansoprazole (LPZ); (b) intermittent P‐CAB; (c) maintenance PPI using LPZ; and (d) maintenance P‐CAB. Results Intermittent P‐CAB was the most cost‐effective, and the number of days for which medication was required with this strategy was fewest. Maintenance PPI was more efficacious, but more costly than intermittent P‐CAB. Maintenance P‐CAB was more efficacious, but more costly than maintenance PPI. Co‐payments were higher for maintenance PPI than for intermittent P‐CAB, and for maintenance P‐CAB than for maintenance PPI, which were considered reasonable for the majority of patients to improve symptoms. Conclusions Intermittent P‐CAB appears to be the strategy of choice for the majority of reflux esophagitis patients in clinical practice. If a patient is not satisfied with the symptom control of the current strategy, switching to a more effective strategy appears to be a reasonable option for the majority of patients. A decision analysis was conducted to investigate the cost‐effectiveness of alternative long‐term strategies for the management of reflux esophagitis in Japan. Intermittent treatment with a potassium‐competitive acid blocker, vonoprazan, appears to be the strategy of choice for the majority of reflux esophagitis patients in clinical practice. If a patient is not satisfied with the symptom control of the current strategy, switching to a more effective strategy appears to be a reasonable option for the majority of patients. |
| Databáze: | OpenAIRE |
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