Health and economic aspects of peptic ulcer disease.

The costs to society of peptic ulcer disease have become exorbitant. These costs are incurred either directly (hospitalization, physician care, and medication costs) or indirectly (loss of productivity due to absenteeism, the loss to society of functioning persons or death of productive persons). Although the results of many studies show that hospitalization for duodenal ulcer disease has decreased, the incidence of perforation, which may be a better index of the disease, has not changed significantly. For many patients and for society, peptic ulceration is a chronic and costly disease. The cost effectiveness of the available treatment modalities are variable and dependent on preventing recurrence. Medical treatment, including the use of antacids and the newer H2-receptor antagonists, seems to be promising. Cimetidine, for example, is effective in treating the acute stage of the disease, but some studies have shown that once the treatment period is over, the ulcers tend to recur. Ranitidine, a newer H2-receptor antagonist, is as effective as cimetidine for healing peptic ulcers and may be more useful as long-term therapy to prevent recurrences. If so, costs to society of this disease can be greatly reduced.