Cost effectiveness of screening for and eradication of Helicobacter pylori in management of dyspeptic patients under 45 years of age

Briggs, Andrew; Sculpher, Mark; Logan, R. P. H.; Aldous, John; Ramsay, Mary; Baron, J. H.

doi:10.1136/bmj.312.7042.1321

Cited by 118 publications

(92 citation statements)

References 16 publications

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“…A decision-analytic model comparing empirical anti-secretory therapy with H. pylori screening found that it would take 5-18 years for savings to accrue if the latter strategy did not influence patient behaviour. 20 However, some recent evidence suggests that knowledge of H. pylori status can reassure patients and may be a cost-effective strategy. 21 Test-and-treat PUD is cured by H. pylori eradication, and there are now safe and relatively inexpensive regimens that effectively treat this organism.…”

Section: Screening For H Pylorimentioning

confidence: 99%

“…(i) benefits are usually limited to a 'avoided costs'and assumptions about effectiveness of different treatments are limited (ii) case-mix is poorly considered; most studies are limited to effects engendered by H. pylori eradication on recurrent PUD alone (iii) modelling approaches are usually limited to one or two strategies with no analysis of different prescribing choices (iv) most studies exclude any high-cost serious outcomes, such as bleeding ulcers or cancers (v) international comparisons, especially with those high USA healthcare costs, are difficult and potentially misleading (vi) most studies are limited to 1-year fixed period; there were only two Markov models 20,229 and no simulation approaches.…”

Section: Introductionmentioning

confidence: 99%

“…All the models found that strategies involving early endoscopy in most or all patients were more costly and no more effective than selective endoscopy. 20,127,228,229 Six studies (in five papers) compared H. pylori test-and-treat with other strategies, [230][231][232][233][234] although only Ebell and colleagues 231 considered differences in effectiveness as well as costs. All six studies found test-andtreat to be the most cost-effective strategy.…”

Section: Introductionmentioning

confidence: 99%

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The management of dyspepsia: a systematic review.

Delaney

Moayyedi²,

Deeks³

et al. 2000

Health Technology Assessment

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK.We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. Competing interests: R Hobbs is a board member of the European Society of Primary Care Gastroenterology, and has received sponsorship for travel and honoraria from a number of biotechnology and pharmaceutical companies for plenary talks and attendance at major scientific congresses and conferences. HTA Published end of 2000This report should be referenced as follows:Delaney B, Moayyedi P, Deeks J, Innes M, Soo S, Barton P, et al. NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and ...

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Section: Screening For H Pylorimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The management of dyspepsia: a systematic review.

Delaney

Moayyedi²,

Deeks³

et al. 2000

Health Technology Assessment

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“…It has been suggested that a strategy of screening dyspeptic patients under 45 prior to endoscopy may be worthwhile, 39 with eradication in those with proven ulcers ('test and scope'). Strategies of screening and eradication for H. pylori in dyspepsia ('test and treat') have been evaluated, and may be more costeffective, 40,41 but the issue of screening the larger asymptomatic population has not been studied in the UK. The case for screening for H. pylori rests on the public health burden of gastric cancer and peptic ulcer disease, and on the availability of a valid screening test for H. pylori and of effective eradication therapy.…”

mentioning

confidence: 99%

The cost-effectiveness of screening for Helicobacter pylori to reduce mortality and morbidity from gastric cancer and peptic ulcer disease: a discrete-event simulation model

Roderick

Davies

Raftery

et al. 2003

Health Technol Assess

113

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK.We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAThe cost-effectiveness of screening for Helicobacter pylori to reduce mortality and morbidity from gastric cancer and peptic ulcer disease: a discrete-event simulation model P Roderick NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and Emerging Applications of Technology (NEAT); and the Methodology Programme.This has meant that the HTA panels can now focus more explicitly on health technologies ('health technologies' are broadly defined to include all interventions used to prom...

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“…A British group have used a simple Markov model to simulate long-term costs and outcomes associated with the treatment of recurrent peptic ulcer over a 10-year period. 31 The authors compared conventional treatment with cimetidine (intermittent therapy, with maintenance treatment after second recurrence or delayed healing), with H. pylori eradication therapy (two attempts, with routine 13C-urea breath testing). Only direct medical costs were estimated, and ulcer complications were not considered.…”

Section: Sek) Costs Of Treating Drug Side Effectsmentioning

confidence: 99%

Clinical economics review: Helicobacter pylori‐associated peptic ulcer disease

Bodger¹,

Daly²,

Heatley³

1997

Aliment Pharmacol Ther

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The high prevalence and chronic nature of peptic ulcer disease have traditionally resulted in a major economic burden on health care systems. In 1991, for example, peptic ulcer disease was estimated to account for over one‐third of all National Health Service expenditure on gastrointestinal diseases. It is now well established that elimination of Helicobacter pylori can lead to a dramatic reduction in gastroduodenal ulcer relapse, with obvious clinical benefits. This review considers the economic implications of the use of H. pylori eradication therapy in peptic ulcer disease.

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Cost effectiveness of screening for and eradication of Helicobacter pylori in management of dyspeptic patients under 45 years of age

Abstract: Objective-To assess the cost effectiveness of screening for and eradicating Helicobacter pylori in patients under 45 years of age presenting with dyspepsia.

Cited by 118 publications

References 16 publications

The management of dyspepsia: a systematic review.

The management of dyspepsia: a systematic review.

The cost-effectiveness of screening for Helicobacter pylori to reduce mortality and morbidity from gastric cancer and peptic ulcer disease: a discrete-event simulation model

Clinical economics review: Helicobacter pylori‐associated peptic ulcer disease

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