Cost Analysis in Helicobacter pylori Eradication Therapy Based on a Database of Health Insurance Claims in Japan
Kengo Tokunaga 1Chihiro Suzuki 2Miyuki Hasegawa 2Ikuo Fujimori 21Department of General Medicine, Kyorin University School of Medicine, Tokyo, Japan; 2Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan Correspondence: Kengo Tokunag...
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| Format: | Article |
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Dove Medical Press
2021-04-01
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| Series: | ClinicoEconomics and Outcomes Research |
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| Online Access: | https://www.dovepress.com/cost-analysis-in-helicobacter-pylori-eradication-therapy-based-on-a-da-peer-reviewed-article-CEOR |
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| author | Tokunaga K Suzuki C Hasegawa M Fujimori I |
| author_facet | Tokunaga K Suzuki C Hasegawa M Fujimori I |
| author_sort | Tokunaga K |
| collection | DOAJ |
| description | Kengo Tokunaga 1Chihiro Suzuki 2Miyuki Hasegawa 2Ikuo Fujimori 21Department of General Medicine, Kyorin University School of Medicine, Tokyo, Japan; 2Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
Correspondence: Kengo TokunagaDepartment of General Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-Shi, Tokyo, 181-8611, JapanTel +81-422-47-5511Email kentoku@ks.kyorin-u.ac.jp
Objective: Cost-benefit is an important consideration for Helicobacter pylori (H. pylori) eradication in Japan, where 1.5 million patients were reported to receive first-line eradication annually. This study aimed to identify the optimal cost-saving triple therapy regimen for H. pylori eradication in Japan.Materials and Methods: This retrospective observational study used data from a largescale, nationwide health insurance claims database (2015‒2018). Using success rates of first-line eradication, mean total costs of first-line and second-line eradications per patient were compared between regimens including a potassium-competitive acid blocker (P-CAB) or a proton pump inhibitor (PPI), and between two clarithromycin (CAM) doses (400 and 800 mg/day). Subgroup analyses by smoking habit or body mass index (BMI) were performed.Results: Among propensity score (age, gender, CAM dose, disease name)-matched patients (P-CAB regimen, n=22,002; PPI regimen, n=22,002), total costs were lower with the P-CAB than the PPI regimen (Japanese yen [JPY] 12,952 vs 13,146) owing to significantly higher first-line eradication rates with the P-CAB regimen (93.6% vs 79.7%; p<0.001). For both regimens, even among current smokers or patients with BMI ≥25 kg/m2, eradication rates did not differ by CAM dose, and total costs were approximately JPY1000 lower with CAM 400 mg/day than with CAM 800 mg/day.Conclusion: High success rate of first-line eradication contributes to saving in total eradication costs by reducing costs of subsequent therapy, irrespective of patients’ smoking status or BMI class. The combination of more potent acid-inhibitory medicine and low-dose CAM may be the optimal regimen in terms of efficacy and cost-benefit in Japan.
Keywords: Japanese claims database, cost analysis, potassium-competitive acid blocker, Helicobacter pylori eradication, clarithromycin-dose, health resource |
| first_indexed | 2024-12-14T19:48:32Z |
| format | Article |
| id | doaj.art-7d1c52d284eb43e499b561de1b6a425b |
| institution | Directory Open Access Journal |
| issn | 1178-6981 |
| language | English |
| last_indexed | 2024-12-14T19:48:32Z |
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| series | ClinicoEconomics and Outcomes Research |
| spelling | doaj.art-7d1c52d284eb43e499b561de1b6a425b2022-12-21T22:49:30ZengDove Medical PressClinicoEconomics and Outcomes Research1178-69812021-04-01Volume 1324125063971Cost Analysis in Helicobacter pylori Eradication Therapy Based on a Database of Health Insurance Claims in JapanTokunaga KSuzuki CHasegawa MFujimori IKengo Tokunaga 1Chihiro Suzuki 2Miyuki Hasegawa 2Ikuo Fujimori 21Department of General Medicine, Kyorin University School of Medicine, Tokyo, Japan; 2Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan Correspondence: Kengo TokunagaDepartment of General Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-Shi, Tokyo, 181-8611, JapanTel +81-422-47-5511Email kentoku@ks.kyorin-u.ac.jp Objective: Cost-benefit is an important consideration for Helicobacter pylori (H. pylori) eradication in Japan, where 1.5 million patients were reported to receive first-line eradication annually. This study aimed to identify the optimal cost-saving triple therapy regimen for H. pylori eradication in Japan.Materials and Methods: This retrospective observational study used data from a largescale, nationwide health insurance claims database (2015‒2018). Using success rates of first-line eradication, mean total costs of first-line and second-line eradications per patient were compared between regimens including a potassium-competitive acid blocker (P-CAB) or a proton pump inhibitor (PPI), and between two clarithromycin (CAM) doses (400 and 800 mg/day). Subgroup analyses by smoking habit or body mass index (BMI) were performed.Results: Among propensity score (age, gender, CAM dose, disease name)-matched patients (P-CAB regimen, n=22,002; PPI regimen, n=22,002), total costs were lower with the P-CAB than the PPI regimen (Japanese yen [JPY] 12,952 vs 13,146) owing to significantly higher first-line eradication rates with the P-CAB regimen (93.6% vs 79.7%; p<0.001). For both regimens, even among current smokers or patients with BMI ≥25 kg/m2, eradication rates did not differ by CAM dose, and total costs were approximately JPY1000 lower with CAM 400 mg/day than with CAM 800 mg/day.Conclusion: High success rate of first-line eradication contributes to saving in total eradication costs by reducing costs of subsequent therapy, irrespective of patients’ smoking status or BMI class. The combination of more potent acid-inhibitory medicine and low-dose CAM may be the optimal regimen in terms of efficacy and cost-benefit in Japan. Keywords: Japanese claims database, cost analysis, potassium-competitive acid blocker, Helicobacter pylori eradication, clarithromycin-dose, health resourcehttps://www.dovepress.com/cost-analysis-in-helicobacter-pylori-eradication-therapy-based-on-a-da-peer-reviewed-article-CEORjapanese claims databasecost analysispotassium-competitive acid blockerhelicobacter pylori eradicationclarithromycin-dosehealth resource |
| spellingShingle | Tokunaga K Suzuki C Hasegawa M Fujimori I Cost Analysis in Helicobacter pylori Eradication Therapy Based on a Database of Health Insurance Claims in Japan ClinicoEconomics and Outcomes Research japanese claims database cost analysis potassium-competitive acid blocker helicobacter pylori eradication clarithromycin-dose health resource |
| title | Cost Analysis in Helicobacter pylori Eradication Therapy Based on a Database of Health Insurance Claims in Japan |
| title_full | Cost Analysis in Helicobacter pylori Eradication Therapy Based on a Database of Health Insurance Claims in Japan |
| title_fullStr | Cost Analysis in Helicobacter pylori Eradication Therapy Based on a Database of Health Insurance Claims in Japan |
| title_full_unstemmed | Cost Analysis in Helicobacter pylori Eradication Therapy Based on a Database of Health Insurance Claims in Japan |
| title_short | Cost Analysis in Helicobacter pylori Eradication Therapy Based on a Database of Health Insurance Claims in Japan |
| title_sort | cost analysis in helicobacter pylori eradication therapy based on a database of health insurance claims in japan |
| topic | japanese claims database cost analysis potassium-competitive acid blocker helicobacter pylori eradication clarithromycin-dose health resource |
| url | https://www.dovepress.com/cost-analysis-in-helicobacter-pylori-eradication-therapy-based-on-a-da-peer-reviewed-article-CEOR |
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