The cost-effectiveness of sequential versus standard triple therapy for Helicobacter pylori eradication in Saudi Arabia
Background: The utilization rate of different treatment regimens for Helicobacter pylori infection is believed to be high; however, the cost-effectiveness of these regimens has not been examined before. Therefore, the aim of this study was to examine the cost-effectiveness of the two commonly prescr...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
|
| Series: | The Saudi Journal of Gastroenterology |
| Subjects: | |
| Online Access: | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2021;volume=27;issue=4;spage=217;epage=222;aulast=AlRuthia |
| _version_ | 1818678056826437632 |
|---|---|
| author | Yazed AlRuthia Majid A Almadi Sadeem Alqahtani Hala Alrasheed Mohammad Al-Owairdhi Fahad Alsohaibani |
| author_facet | Yazed AlRuthia Majid A Almadi Sadeem Alqahtani Hala Alrasheed Mohammad Al-Owairdhi Fahad Alsohaibani |
| author_sort | Yazed AlRuthia |
| collection | DOAJ |
| description | Background: The utilization rate of different treatment regimens for Helicobacter pylori infection is believed to be high; however, the cost-effectiveness of these regimens has not been examined before. Therefore, the aim of this study was to examine the cost-effectiveness of the two commonly prescribed treatments for H. pylori infection.
Methods: The data of an open-label, single-center, randomized trial that compared the efficacy of sequential therapy (SQT) (i.e., esomeprazole 20 mg twice daily for 10 days, amoxicillin 1000 mg twice daily for 5 days, then clarithromycin 500 mg and tinidazole 500 mg twice daily for 5 days) to standard triple therapy (STT) (i.e., esomeprazole 20 mg, amoxicillin 1000 mg, and clarithromycin 500 twice daily for 14 days) in the eradication of H. pylori, as confirmed by the negative urea breath test (UBT), were used. Propensity score matching bin bootstrapping, with 10,000 replications and bias correction was conducted to generate the 95% confidence limits. Moreover, probabilistic sensitivity analysis was conducted by varying both the eradication rates and the costs of treatment regimens.
Results: There were 82 and 88 patients who were on SQT and STT, respectively. Patients' mean age was 47 years, and approximately 55% of them were females. The mean treatment costs were SAR 2,075.51 (USD 553.47) and SAR 2,629.26 (USD 701.14) for SQT and STT, respectively. The mean eradication rates for SQT and STT were 63.41% and 67.05%, respectively. The mean difference in costs and eradication rates for SQT versus STT were SAR − 550.75 (95% CI: −563.84- −537.69) and − 3.64% (95% CI: −6.98- 5.88). The use of SQT was more likely to be cost saving and more effective with 56.25% confidence level, in comparison to STT.
Conclusion: The use of SQT in the treatment of H. pylori seems to be more cost-effective than STT. |
| first_indexed | 2024-12-17T09:09:12Z |
| format | Article |
| id | doaj.art-108f5043f250400687757c28a5c14cc9 |
| institution | Directory Open Access Journal |
| issn | 1319-3767 1998-4049 |
| language | English |
| last_indexed | 2024-12-17T09:09:12Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Saudi Journal of Gastroenterology |
| spelling | doaj.art-108f5043f250400687757c28a5c14cc92022-12-21T21:55:19ZengWolters Kluwer Medknow PublicationsThe Saudi Journal of Gastroenterology1319-37671998-40492021-01-0127421722210.4103/sjg.sjg_536_20The cost-effectiveness of sequential versus standard triple therapy for Helicobacter pylori eradication in Saudi ArabiaYazed AlRuthiaMajid A AlmadiSadeem AlqahtaniHala AlrasheedMohammad Al-OwairdhiFahad AlsohaibaniBackground: The utilization rate of different treatment regimens for Helicobacter pylori infection is believed to be high; however, the cost-effectiveness of these regimens has not been examined before. Therefore, the aim of this study was to examine the cost-effectiveness of the two commonly prescribed treatments for H. pylori infection. Methods: The data of an open-label, single-center, randomized trial that compared the efficacy of sequential therapy (SQT) (i.e., esomeprazole 20 mg twice daily for 10 days, amoxicillin 1000 mg twice daily for 5 days, then clarithromycin 500 mg and tinidazole 500 mg twice daily for 5 days) to standard triple therapy (STT) (i.e., esomeprazole 20 mg, amoxicillin 1000 mg, and clarithromycin 500 twice daily for 14 days) in the eradication of H. pylori, as confirmed by the negative urea breath test (UBT), were used. Propensity score matching bin bootstrapping, with 10,000 replications and bias correction was conducted to generate the 95% confidence limits. Moreover, probabilistic sensitivity analysis was conducted by varying both the eradication rates and the costs of treatment regimens. Results: There were 82 and 88 patients who were on SQT and STT, respectively. Patients' mean age was 47 years, and approximately 55% of them were females. The mean treatment costs were SAR 2,075.51 (USD 553.47) and SAR 2,629.26 (USD 701.14) for SQT and STT, respectively. The mean eradication rates for SQT and STT were 63.41% and 67.05%, respectively. The mean difference in costs and eradication rates for SQT versus STT were SAR − 550.75 (95% CI: −563.84- −537.69) and − 3.64% (95% CI: −6.98- 5.88). The use of SQT was more likely to be cost saving and more effective with 56.25% confidence level, in comparison to STT. Conclusion: The use of SQT in the treatment of H. pylori seems to be more cost-effective than STT.http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2021;volume=27;issue=4;spage=217;epage=222;aulast=AlRuthiacost-effectivenesshelicobacter pylorisaudi arabiasequential therapytriple therapy |
| spellingShingle | Yazed AlRuthia Majid A Almadi Sadeem Alqahtani Hala Alrasheed Mohammad Al-Owairdhi Fahad Alsohaibani The cost-effectiveness of sequential versus standard triple therapy for Helicobacter pylori eradication in Saudi Arabia The Saudi Journal of Gastroenterology cost-effectiveness helicobacter pylori saudi arabia sequential therapy triple therapy |
| title | The cost-effectiveness of sequential versus standard triple therapy for Helicobacter pylori eradication in Saudi Arabia |
| title_full | The cost-effectiveness of sequential versus standard triple therapy for Helicobacter pylori eradication in Saudi Arabia |
| title_fullStr | The cost-effectiveness of sequential versus standard triple therapy for Helicobacter pylori eradication in Saudi Arabia |
| title_full_unstemmed | The cost-effectiveness of sequential versus standard triple therapy for Helicobacter pylori eradication in Saudi Arabia |
| title_short | The cost-effectiveness of sequential versus standard triple therapy for Helicobacter pylori eradication in Saudi Arabia |
| title_sort | cost effectiveness of sequential versus standard triple therapy for helicobacter pylori eradication in saudi arabia |
| topic | cost-effectiveness helicobacter pylori saudi arabia sequential therapy triple therapy |
| url | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2021;volume=27;issue=4;spage=217;epage=222;aulast=AlRuthia |
| work_keys_str_mv | AT yazedalruthia thecosteffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia AT majidaalmadi thecosteffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia AT sadeemalqahtani thecosteffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia AT halaalrasheed thecosteffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia AT mohammadalowairdhi thecosteffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia AT fahadalsohaibani thecosteffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia AT yazedalruthia costeffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia AT majidaalmadi costeffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia AT sadeemalqahtani costeffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia AT halaalrasheed costeffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia AT mohammadalowairdhi costeffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia AT fahadalsohaibani costeffectivenessofsequentialversusstandardtripletherapyforhelicobacterpylorieradicationinsaudiarabia |