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- Title
Helicobacter pylori "Test‐and‐Treat" strategy with urea breath test: A cost‐effective strategy for the management of dyspepsia and the prevention of ulcer and gastric cancer in Spain—Results of the Hp‐Breath initiative.
- Authors
Beresniak, Ariel; Malfertheiner, Peter; Franceschi, Francesco; Liebaert, Francois; Salhi, Hocine; Gisbert, Javier P.
- Abstract
Background: Data from clinical trials comparing Helicobacter pylori (H. pylori) management strategies in patients with dyspepsia are limited. Cost‐effectiveness simulation models might help to identify the optimal strategy. Objective: To assess the cost‐effectiveness of the H. pylori "Test and Treat" (T&T) strategy including the use of urea breath test (UBT) vs symptomatic treatment (ST) and vs upper gastrointestinal endoscopy (UGE) as a first procedure in patients with dyspepsia. Methods: Three main strategies: "T&T" strategy including the use of UBT, "UGE" and "ST" have been compared using cost‐effectiveness models developed in accordance with the Spanish medical practice. For the model simulations, a time horizon of 4 weeks was considered for the endpoint "Dyspepsia symptoms relief" and 10 years when using "Peptic ulcer avoided" and "Gastric cancer avoided" endpoints. Results: For the endpoint "Dyspepsia symptoms relief", T&T strategy appears to be the most cost‐effective (883€/success) compared to UGE strategy and to ST strategy (respectively 1628€ and 990€/success). For the endpoint "Probability of peptic ulcer", the T&T strategy appears to be the most cost‐effective (421€/peptic ulcer avoided/y) compared to UGE strategy and ST strategy (respectively 728€ and 632€/peptic ulcer avoided/y). For the endpoint "Gastric cancer avoided", the T&T strategy appears to be the most cost‐effective (524€/gastric cancer avoided/y) compared to UGE strategy and "ST" strategy (respectively 716€ and 696€/gastric cancer avoided/y). Conclusions: T&T strategy including the use of UBT is the most cost‐effective medical approach for management of dyspepsia and for the prevention of ulcer and gastric cancer.
- Subjects
SPAIN; STOMACH cancer; HELICOBACTER pylori; BREATH tests; INDIGESTION; PEPTIC ulcer
- Publication
Helicobacter, 2020, Vol 25, Issue 4, p1
- ISSN
1083-4389
- Publication type
Article
- DOI
10.1111/hel.12693