Premium
Low‐dose or standard‐dose proton pump inhibitors for maintenance therapy of gastro‐oesophageal reflux disease: a cost‐effectiveness analysis
Author(s) -
You J. H. S.,
Lee A. C. M.,
Wong S. C. Y.,
Chan F. K. L.
Publication year - 2003
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01526.x
Subject(s) - proton pump inhibitor , medicine , gerd , histamine , maintenance dose , infusion pump , reflux , gastroenterology , pharmacology , disease , anesthesia
Summary Background : Studies on the use of low‐dose proton pump inhibitor for the maintenance therapy of gastro‐oesophageal reflux disease have shown that it might be comparable with standard‐dose proton pump inhibitor treatment and superior to standard‐dose histamine‐2 receptor antagonist therapy. Aim : To compare the impact of standard‐dose histamine‐2 receptor antagonist, low‐dose proton pump inhibitor and standard‐dose proton pump inhibitor treatment for the maintenance therapy of gastro‐oesophageal reflux disease on symptom control and health care resource utilization from the perspective of a public health organization in Hong Kong. Methods : A Markov model was designed to simulate, over 12 months, the economic and clinical outcomes of gastro‐oesophageal reflux disease patients treated with standard‐dose histamine‐2 receptor antagonist, low‐dose proton pump inhibitor and standard‐dose proton pump inhibitor. The transition probabilities were derived from the literature. Resource utilization was retrieved from a group of gastro‐oesophageal reflux disease patients in Hong Kong. Sensitivity analysis was conducted to examine the robustness of the model. Results : The standard‐dose proton pump inhibitor strategy was associated with the highest numbers of symptom‐free patient‐years (0.954 years) and quality‐adjusted life‐years gained (0.999 years), followed by low‐dose proton pump inhibitor and standard‐dose histamine‐2 receptor antagonist. The direct medical cost per patient in the standard‐dose proton pump inhibitor group (US$904) was lower than those of the low‐dose proton pump inhibitor and standard‐dose histamine‐2 receptor antagonist groups. Conclusions : The standard‐dose proton pump inhibitor strategy appears to be the most effective and least costly for the maintenance management of patients with gastro‐oesophageal reflux disease in Hong Kong.