A cost-effectiveness analysis of prescribing strategies in managing heartburn

Lansoprazole Compared With Ranitidine for the Treatment of Nonerosive Gastroesophageal Reflux Disease

“…29,30 While it is not surprising that empiric treatment of patients with GERD using a proton pump inhibitor is more cost-effective than endoscopy, recent findings suggest that the use of a proton pump inhibitor is only marginally more costly than the use of an H2RA, while being significantly more effective at relieving symptoms, 31 maintaining symptomatic remission in those with mild reflux, 32 and improving quality of life. 29 In a study of 685 patients with suspected GERD who were randomized to receive either omeprazole or ranitidine, significantly more patients treated with omeprazole were heartburn-free at 4, 8, 12, and 16 weeks compared with those treated with ranitidine. 31 The overall cost of care during these 16 weeks was only $23 higher for those treated with omeprazole compared with those treated with ranitidine, primarily as a result of a reduced number of endoscopies being performed.…”

“…In addition to providing greater symptomatic relief, it has been suggested that the empiric use of proton pump inhibitors is a cost-effective approach to the management of these patients. 29,30 While it is not surprising that empiric treatment of patients with GERD using a proton pump inhibitor is more cost-effective than endoscopy, recent findings suggest that the use of a proton pump inhibitor is only marginally more costly than the use of an H2RA, while being significantly more effective at relieving symptoms, 31 maintaining symptomatic remission in those with mild reflux, 32 and improving quality of life. 29 In a study of 685 patients with suspected GERD who were randomized to receive either omeprazole or ranitidine, significantly more patients treated with omeprazole were heartburn-free at 4, 8, 12, and 16 weeks compared with those treated with ranitidine.…”