Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases
AIM. To estimate the pharmacoeconomic parameters of treatment in patients with Helicobacter pylori-associated diseases when using 6 eradication therapy (ET) regimens. MATERIALS AND METHODS. The investigation enrolled a total of 231 patients who received anti-Helicobacter pylori therapy according to...
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| Format: | Article |
| Language: | Russian |
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"Consilium Medicum" Publishing house
2014-08-01
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| Series: | Терапевтический архив |
| Subjects: | |
| Online Access: | https://ter-arkhiv.ru/0040-3660/article/view/31556 |
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| author | A A Samsonov V B Grechushnikov D N Andreev G L Iurenev T I Korovina Iu A Lezhneva I V Maev |
| author_facet | A A Samsonov V B Grechushnikov D N Andreev G L Iurenev T I Korovina Iu A Lezhneva I V Maev |
| author_sort | A A Samsonov |
| collection | DOAJ |
| description | AIM. To estimate the pharmacoeconomic parameters of treatment in patients with Helicobacter pylori-associated diseases when using 6 eradication therapy (ET) regimens. MATERIALS AND METHODS. The investigation enrolled a total of 231 patients who received anti-Helicobacter pylori therapy according to the intention-to-treat (ITT) principle, including 229 patients who met the protocol requirements, i.e. who completed the prescribed per-protocol (PP) treatment: 106 patients with duodenal bulb ulcer disease, 2 with gastric ulcer, 90 with erosive gastritis, and 31 patients with non-atrophic gastritis. In an outpatient setting, the patients received one of the 6 ET regimens: OAC, RBMA, RBCA, EBCA, sequential OACM therapy, and modified sequential OACMB therapy (O - omeprazole; A - amoxicillin; C - clarithromycin; B - bismuth tripotassium dicitrate, R - rabeprazole; M - metronidazole; E - esomeprazole). Treatment costs were calculated only from direct drug expenditures. The effective cost coefficient (Keff) was determined from the cost/treatment efficiency ratio: Keff=cos/eff, where the cost was the average total costs; the eff was efficiency (%). RESULTS. The modified sequential OACMB therapy has proven to be more cost-efficient than the other regimens as it has a lower Keff (14). The RBMA regimens can overcome an 80% ET barrier (82.4%); however, in this case the Keff is 21.5. the sequential OACM therapy can also overcome an 80% ET barrier (84.8%); the Keff being 10.8. Incorporation of the bismuth preparation can achieve a more noticeable therapeutic effect up to 95.4%. The EBCA regimen has turned out to be most expensive with the highest Keff of 36.9. The RBCA regimen is most effective with the least Keff of 29; the therapeutic effect is 96.7%. CONCLUSION. The clinical cost-efficiency of ET is enhanced by the incorporation of the bismuth preparation for the treatment of patients with H. pylori-associated diseases. The modified sequential OACMB therapy can overcome resistance to clarithromycin and metronidazole with a good cost-efficiency. |
| first_indexed | 2024-04-12T04:31:26Z |
| format | Article |
| id | doaj.art-9d16d02b835b4d0381f5a208ff1b3d02 |
| institution | Directory Open Access Journal |
| issn | 0040-3660 2309-5342 |
| language | Russian |
| last_indexed | 2024-04-12T04:31:26Z |
| publishDate | 2014-08-01 |
| publisher | "Consilium Medicum" Publishing house |
| record_format | Article |
| series | Терапевтический архив |
| spelling | doaj.art-9d16d02b835b4d0381f5a208ff1b3d022022-12-22T03:47:56Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422014-08-01868566128573Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseasesA A SamsonovV B GrechushnikovD N AndreevG L IurenevT I KorovinaIu A LezhnevaI V MaevAIM. To estimate the pharmacoeconomic parameters of treatment in patients with Helicobacter pylori-associated diseases when using 6 eradication therapy (ET) regimens. MATERIALS AND METHODS. The investigation enrolled a total of 231 patients who received anti-Helicobacter pylori therapy according to the intention-to-treat (ITT) principle, including 229 patients who met the protocol requirements, i.e. who completed the prescribed per-protocol (PP) treatment: 106 patients with duodenal bulb ulcer disease, 2 with gastric ulcer, 90 with erosive gastritis, and 31 patients with non-atrophic gastritis. In an outpatient setting, the patients received one of the 6 ET regimens: OAC, RBMA, RBCA, EBCA, sequential OACM therapy, and modified sequential OACMB therapy (O - omeprazole; A - amoxicillin; C - clarithromycin; B - bismuth tripotassium dicitrate, R - rabeprazole; M - metronidazole; E - esomeprazole). Treatment costs were calculated only from direct drug expenditures. The effective cost coefficient (Keff) was determined from the cost/treatment efficiency ratio: Keff=cos/eff, where the cost was the average total costs; the eff was efficiency (%). RESULTS. The modified sequential OACMB therapy has proven to be more cost-efficient than the other regimens as it has a lower Keff (14). The RBMA regimens can overcome an 80% ET barrier (82.4%); however, in this case the Keff is 21.5. the sequential OACM therapy can also overcome an 80% ET barrier (84.8%); the Keff being 10.8. Incorporation of the bismuth preparation can achieve a more noticeable therapeutic effect up to 95.4%. The EBCA regimen has turned out to be most expensive with the highest Keff of 36.9. The RBCA regimen is most effective with the least Keff of 29; the therapeutic effect is 96.7%. CONCLUSION. The clinical cost-efficiency of ET is enhanced by the incorporation of the bismuth preparation for the treatment of patients with H. pylori-associated diseases. The modified sequential OACMB therapy can overcome resistance to clarithromycin and metronidazole with a good cost-efficiency.https://ter-arkhiv.ru/0040-3660/article/view/31556helicobacter pylorieradication therapyproton pump inhibitorsbismuth tripotassium dicitrateeffective cost coefficienthelicobacter pylori |
| spellingShingle | A A Samsonov V B Grechushnikov D N Andreev G L Iurenev T I Korovina Iu A Lezhneva I V Maev Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases Терапевтический архив helicobacter pylori eradication therapy proton pump inhibitors bismuth tripotassium dicitrate effective cost coefficient helicobacter pylori |
| title | Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases |
| title_full | Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases |
| title_fullStr | Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases |
| title_full_unstemmed | Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases |
| title_short | Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases |
| title_sort | pharmacoeconomic evaluation of treatment in patients with helicobacter pylori associated diseases |
| topic | helicobacter pylori eradication therapy proton pump inhibitors bismuth tripotassium dicitrate effective cost coefficient helicobacter pylori |
| url | https://ter-arkhiv.ru/0040-3660/article/view/31556 |
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