Economic and health impacts of introducing Helicobacter pylori eradication strategy into national gastric cancer policy in Japan: A cost‐effectiveness analysis

Abstract

Background Helicobacter pylori (H. pylori) eradication reduces gastric cancer risk. Since 2013, a population‐wide H. pylori eradication strategy for patients with chronic gastritis has begun to prevent gastric cancer in Japan. The aim of this study was to evaluate the economic and health effects of H. pylori eradication strategy in national gastric cancer prevention program. Materials and Methods We developed a cohort state‐transition model for H. pylori eradication and no eradication over a lifetime horizon from a healthcare payer perspective, and performed one‐way and probabilistic sensitivity analyses. We targeted a hypothetical cohort of H. pylori‐positive patients aged 20, 30, 40, 50, 60, 70, and 80. The main outcomes were costs, quality‐adjusted life‐years (QALYs), life expectancy life‐years (LYs), incremental cost‐effectiveness ratios, gastric cancer cases, and deaths from gastric cancer. Results H. pylori eradication was more effective and cost‐saving for all age groups than no eradication. Sensitivity analyses showed strong robustness of the results. From 2013‐2019 for 8.50 million patients, H. pylori eradication saved US$3.75 billion, increased 11.11 million QALYs and 0.45 million LYs, and prevented 284,188 cases and 65,060 deaths. For 35.59 million patients without eradication, H. pylori eradication has the potential to save US$14.82 billion, increase 43.10 million QALYs and 1.66 million LYs, and prevent 1,084,532 cases and 250,256 deaths. Conclusions National policy using population‐wide H. pylori eradication to prevent gastric cancer has significant cost savings and health impacts for young‐, middle‐, and old‐aged individuals in Japan. The findings strongly support the promotion of H. pylori eradication strategy for all age groups in high‐incidence countries.

Helicobacter pylori Infection in Geriatric Patients: Current Situation and Treatment Regimens

“…A study in Japan found that from 2013 to 2019, H. pylori eradication was economical and reduced the incidence of and mortality caused by gastric cancer in patients aged 20–80 years compared to those not having undergone eradication. Among the patients that had received eradication therapy, those aged 60 years had the highest cost benefits and best health outcomes ( 110 ). The use of H. pylori eradication as a strategy for the prevention of gastric cancer can not only save lives, but also greatly reduce the healthcare-related economic burden on the national budget ( 110 ).…”

“…Among the patients that had received eradication therapy, those aged 60 years had the highest cost benefits and best health outcomes ( 110 ). The use of H. pylori eradication as a strategy for the prevention of gastric cancer can not only save lives, but also greatly reduce the healthcare-related economic burden on the national budget ( 110 ).…”

“…Some economic analyses suggest that H. pylori screening and eradication are cost-effective for preventing gastric cancer, especially in high-risk areas (103)(104)(105)(106)(107)(108)(109)(110)(111). A study in Japan found that from 2013 to 2019, H. pylori eradication was economical and reduced the incidence of and mortality caused by gastric cancer in patients aged 20-80 years compared to those not having undergone eradication.…”

Economic and health impacts of Helicobacter pylori eradication strategy for the treatment of peptic ulcer disease: A cost‐effectiveness analysis

“…We previously demonstrated that H. pylori eradication strategy for gastric cancer prevention is cost-effective [19][20][21] and provides significant cumulative lifetime cost savings and great cumulative lifetime health benefits. 21 This study suggests that H. pylori eradication strategy provides significant cost savings for H. pylori-positive patients with peptic ulcers, and contributes to the reduction in peptic ulcer morbidity and mortality compared with PPI therapy strategy.…”

What is the general Chinese public’s awareness of and attitudes towardsHelicobacter pyloriscreening and associated health behaviours? A cross-sectional study

“…However, although eradication of HP to prevent GC has a cost–benefit advantage,10 China lacks national policies or protocols for HP in GC screening 11. HP infection is usually asymptomatic,12 and China has a large population and relatively poor medical and health resources; therefore, opportunistic screening of asymptomatic people is currently the main approach 13 14.…”