幽门螺杆菌感染根除中检测与治疗及经验性治疗策略的经济学评价；伊朗成年人群中的马尔可夫模型

Economic evaluation of test-and-treat and empirical treatment strategies in the eradication of Helicobacter pylori infection; A Markov model in an Iranian adult population.

作者信息

Mazdaki Alireza, Ghiasvand Hesam, Sarabi Asiabar Ali, Naghdi Seyran, Aryankhesal Aidin

机构信息

MA in Public Administration, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.

PhD Candidate of Health Economics, Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical, Kerman, Iran.

出版信息

Med J Islam Repub Iran. 2016 Feb 14;30:327. eCollection 2016.

BACKGROUND

Helicobacter pylori may cause many gastrointestinal problems in developing countries such as Iran. We aimed to analyze the cost- effectiveness and cost- utility of the test-and-treat and empirical treatment strategies in managing Helicobacter pylori infection.

METHODS

This was a Markov based economic evaluation. Effectiveness was defined as the symptoms free numbers and QALYs in 100,000 hypothetical adults. The sensitivity analysis was based on Monte Carlo approach.

RESULTS

In the test- and- treat strategy, if the serology is the first diagnostic test vs. histology, the cost per symptoms free number would be 291,736.1 Rials while the cost per QALYs would be 339,226.1 Rials. The cost per symptoms free number and cost per QALYs when the 13 C-UBT was used as the first diagnostic test vs. serology was 1,283,200 and 1,492,103 Rials, respectively. In the empirical strategy, if histology is used as the first diagnostic test vs. 13 CUBT, the cost per symptoms free numbers and cost per QALYs would be 793,234 and 955,698 Rials, respectively. If serology were used as the first diagnostic test vs. histology, the cost per symptoms free and QALYs would be 793,234 and 368941 Rials, respectively.

CONCLUSION

There was no significant and considerable dominancy between the alternatives and the diagnostic tests.

背景

幽门螺杆菌可能会在伊朗等发展中国家引发多种胃肠道问题。我们旨在分析检测与治疗策略和经验性治疗策略在管理幽门螺杆菌感染方面的成本效益和成本效用。

方法

这是一项基于马尔可夫模型的经济评估。有效性定义为100,000名假设成年人中无症状的人数和质量调整生命年。敏感性分析基于蒙特卡洛方法。

结果

在检测与治疗策略中，如果血清学作为首选诊断测试与组织学相比，每无症状人数的成本将为291,736.1里亚尔，而每质量调整生命年的成本将为339,226.1里亚尔。当将13C尿素呼气试验作为首选诊断测试与血清学相比时，每无症状人数的成本和每质量调整生命年的成本分别为1,283,200里亚尔和1,492,103里亚尔。在经验性策略中，如果组织学作为首选诊断测试与13C尿素呼气试验相比，每无症状人数的成本和每质量调整生命年的成本分别为793,234里亚尔和955,698里亚尔。如果血清学作为首选诊断测试与组织学相比，每无症状人数和每质量调整生命年的成本分别为793,234里亚尔和368,941里亚尔。