English, Article edition: Cost Effectiveness in Canada of a Multidrug Prepackaged Regimen (Hp-PAC(R)) Use of tradenames is for product identification only and does not imply endorsement. for Helicobacter pylori Eradication Karen Agro; Gordon Blackhouse; Ron Goeree; ...

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Bookmark: http://trove.nla.gov.au/version/118825
Physical Description
  • article
Language
  • English

Edition details

Title
  • Cost Effectiveness in Canada of a Multidrug Prepackaged Regimen (Hp-PAC(R)) Use of tradenames is for product identification only and does not imply endorsement. for Helicobacter pylori Eradication
Author
  • Karen Agro
  • Gordon Blackhouse
  • Ron Goeree
  • Andrew R. Willan
  • Jia-Qing Huang
  • Richard H. Hunt
  • Bernie J. O'Brien
Physical Description
  • article
Notes
  • Objective: To assess the cost effectiveness of a multidrug prepackaged regimen for Helicobacter pylori, the Hp-PAC(R) (lansoprazole 30mg, clarithromycin 500mg, amoxicillin 1g, all twice daily), relative to alternative pharmacological strategies in the management of confirmed duodenal ulcer over a 1-year period from 2 perspectives: (i) a strict healthcare payer perspective (Ontario Ministry of Health) excluding the patient copayment; and (ii) a healthcare payer perspective including the patient copayment. Design: A decision-analytical model was developed to estimate expected per patient costs [1998 Canadian dollars ($Can)], weeks without ulcer and symptomatic ulcer recurrences for the Hp-PAC(R) compared with: proton pump inhibitor (PPI)-clarithromycin-amoxicillin (PPI-CA), PPI-clarithromycin-metronidazole (PPI-CM), PPI-amoxicillin-metronidazole (PPI-AM) and ranitidine-bismuth-metronidazole-tetracycline (RAN-BMT). Main outcome measures and results: All PPI-based regimens had higher expected costs but better outcomes relative to RAN-BMT. From a strict healthcare payer perspective, PPI-CM ($Can209) yielded lower expected costs than PPI-CA ($Can221) and slightly lower costs than Hp-PAC(R) ($Can211). However, these 3 regimens all shared identical outcomes (51.2 weeks without ulcer). When the current Ontario, Canada, $Can2 patient copayment was added to the dispensing fee, Hp-PAC(R) yielded lower costs ($Can214) than PPI-CM ($Can216). Conclusion: From a strict healthcare payer perspective, Hp-PAC(R) is weakly dominated by PPI-CM with an incremental cost effectiveness (relative to RAN-BMT) of $Can5.77 per ulcer week averted. When the patient copayment is added to this perspective, Hp-PAC(R) weakly dominates PPI-CM ($Can5 per ulcer week averted). Regardless of perspective, Hp-PAC(R) and PPI-CM differed by only $Can2 per patient over 1 year and the expected time without ulcer was 51.2 weeks for both. More data on the clinical and statistical differences in H. pylori eradication with Hp-PAC(R) and PPI-CM would be useful. This analysis does not include the possible advantage of Hp-PAC(R) in terms of compliance and antibacterial resistance.
  • Amoxicillin, Clarithromycin, Cost effectiveness, Duodenal ulcer, Helicobacter pylori eradication therapies, Lansoprazole, Metronidazole, Pharmacoeconomics, Ranitidine bismutrex, Tetracycline
  • RePEc:wkh:phecon:v:19:y:2001:i:8:p:831-843
Language
  • English
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