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在服用非甾体抗炎药和/或阿司匹林的患者中,幽门螺杆菌筛查和根除的成本效益。

Cost Effectiveness Associated with Helicobacter pylori Screening and Eradication in Patients Taking Nonsteroidal Anti-Inflammatory Drugs and/or Aspirin.

机构信息

School of Pharmacy, Sungkyunkwan University, Suwon, Korea.

出版信息

Gut Liver. 2013 Mar;7(2):182-9. doi: 10.5009/gnl.2013.7.2.182. Epub 2013 Mar 14.

Abstract

BACKGROUND/AIMS: This study was performed to investigate the cost effectiveness of Helicobacter pylori screening/eradication in South Korean patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and/or aspirin.

METHODS

A decision Markov model was used to estimate the effectiveness and economic impact of an H. pylori screening/eradication strategy compared to a no-screening strategy among patients who were included in the model at the age of 40 years. Utility weights were applied to four of the health status groups to reflect quality-adjusted life years (QALY). The costs of screening, H. pylori eradication, and managing peptic ulcer and ulcer complications were obtained from South Korea-specific data.

RESULTS

The total costs per patient were US $2,454 for the H. pylori screening/eradication and US $3,182 for the no-screening strategy. The QALYs for the two strategies were 16.05 and 15.73, respectively. The results were robust for the analyses of all different cohort groups who entered the model at the age of 30, 50, or 60 years and for NSAIDs-naïve patients. Through the probabilistic sensitivity analysis, the robustness of our study's results was also determined.

CONCLUSIONS

The H. pylori screening/eradication strategy was found to be less expensive and more effective compared to the no-screening strategy among South Korean patients taking NSAIDs and/or aspirin.

摘要

背景/目的:本研究旨在探讨在韩国接受非甾体抗炎药(NSAIDs)和/或阿司匹林治疗的患者中,进行幽门螺杆菌筛查/根除的成本效益。

方法

采用决策马尔可夫模型,比较了对模型中 40 岁患者进行幽门螺杆菌筛查/根除策略与不筛查策略的效果和经济影响。将效用权重应用于四个健康状况组,以反映质量调整生命年(QALY)。筛查、幽门螺杆菌根除以及治疗消化性溃疡和溃疡并发症的成本来自韩国特定数据。

结果

幽门螺杆菌筛查/根除策略的每位患者总成本为 2454 美元,不筛查策略为 3182 美元。两种策略的 QALY 分别为 16.05 和 15.73。对于在 30、50 或 60 岁进入模型的所有不同队列组以及 NSAIDs 初治患者的分析,结果均具有稳健性。通过概率敏感性分析,还确定了我们研究结果的稳健性。

结论

与不筛查策略相比,在韩国接受 NSAIDs 和/或阿司匹林治疗的患者中,进行幽门螺杆菌筛查/根除策略的成本更低,效果更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e8a/3607772/a1289a96c1e5/gnl-7-182-g001.jpg

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