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Background  Initial assessment of dyspepsia often includes noninvasive testing for  Helicobacter pylori  infection. Commercially available tests vary widely in cost and accuracy. Although there is extensive literature on the cost-effectiveness of  H. pylori  treatment, there is little information comparing the cost-effectiveness of various currently used, noninvasive testing strategies.    Methods  A Markov simulation was used to calculate cost per symptom-free year and cost per correct diagnosis. Uncertainty in outcomes was estimated using probabilistic sensitivity analysis.    Results  Under the baseline assumptions, cost per symptom-free year was $122 for empiric proton pump inhibitor (PPI) trial, and costs for the noninvasive test strategies ranged from $123 (stool antigen) to $129 (IgG/IgA combined serology). Confidence intervals had significant overlap.    Conclusions  Under our assumptions for how testing for  H. pylori  infection is employed in United States medical practice, the available noninvasive tests all have similar cost-effectiveness between one another as well as with empiric PPI trial.

bmc health services research

Cost-effectiveness of six strategies for Helicobacter pyloridiagnosis and management in uninvestigated dyspepsia assuming a high resource intensity practice pattern