Cost-Effectiveness Analysis of Helicobacter Pylori Diagnostic Methods in the Patients with Atrophic Gastritis

Shimbo, Takuro; Ohde, Sachiko; Deshpande, Gautam A.

doi:10.1016/s0016-5085(17)31706-7

Cited by 1 publication

(5 citation statements)

References 31 publications

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“…Three articles [ 37 , 38 , 39 ] studied the cost-effectiveness of alternative initial strategies of diagnosing H. pylori infection in patients attending primary care with any predominant symptom. Table 4 shows the models’ main characteristics.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies [ 37 , 39 ] found that the initial test for H. pylori was the most cost-effective strategy, although this result depended on the prevalence of the H. pylori infection. The other article [ 38 ] introduced AMR into its analysis, considering that, if the first antibiotic treatment failed due to clarithromycin-resistance, the patient was treated with metronidazole. In this case, testing for H. pylori was not cost effective in the given modest prevalence of clarithromycin resistance.…”

Section: Resultsmentioning

confidence: 99%

“…The standard treatment for H. pylori infection is based on high doses of combined antibiotics and second-line antibiotics with more risk of AMR [ 15 ]. The most recently published articles consider AMR in their analysis, decreasing the eradication figures [ 30 , 32 , 38 ]. In these articles, the study is performed in a country where antibiotics can be occasionally obtained over the counter (year 2006, China) or in high-resistance areas (Greece and Japan), leading to AMR causing a higher failure rate.…”

Section: Discussionmentioning

confidence: 99%

“…The inclusion of AMR into the analysis has been done by reducing the rate of antibiotic efficacy but other alternatives such as increasing treatment costs have not been found in any article. Interestingly, AMR can change the results of the most cost-effective strategy to diagnose H. pylori infections [ 38 ]. Furthermore, the CHEERS checklist focused on methodological issues, thus the inclusion of AMR is not considered as an important item to be reported.…”

Section: Discussionmentioning

confidence: 99%

“…Only three articles performed a Markov model and two of them [ 31 , 44 ] considered an extended time horizon. The most frequent clinical outcome reported was cost or length of time until correct diagnosis [ 32 , 33 , 37 , 38 , 39 , 45 ], cost per appropriate treatment prescribed [ 27 , 30 , 34 , 45 ] and second-line antibiotics treatment safely avoided [ 36 ], which highlights the importance of a correct diagnosis to reduce unnecessary antibiotic treatment. Also, quality adjusted life year (QALYs) [ 35 , 44 ] and days free from disease [ 28 , 29 , 31 ] were used.…”

Section: Discussionmentioning

confidence: 99%

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Efficiency of Diagnostic Testing for Helicobacter pylori Infections—A Systematic Review

et al. 2021

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Background: The most recommended treatment for a Helicobacter pylori infection is high doses of combined antibiotics. The objective of this article is to perform a systematic review of the economic evaluation studies applied to assess the efficiency of diagnostic testing for H. pylori infections, so that their main characteristics can be identified and to learn from the literature how the antimicrobial resistance (AMR) issue is incorporated into these economic evaluations. Methods: We conducted a systematic review to compare the costs and clinical effectiveness of diagnostic strategies for H. pylori infections. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and extracted the items from the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results: We found thirteen articles that were of good quality according to CHEERS: six studies focused on diagnostics of Helicobacter pylori infections associated with dyspepsia and four on duodenal ulcers. Testing was found to be the most cost-effective strategy in eight articles. Four studies considered AMR. Conclusions: Testing was more cost-effective than empirical treatment, except in cases of high prevalence (as with developing countries) or when patients could be stratified according to their comorbidities. The introduction of AMR into the model may change the efficiency of the testing strategy.

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Section: Resultsmentioning

confidence: 99%