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Low-dose or standard-dose proton pump inhibitors for maintenance therapy of gastro-oesophageal reflux disease: a cost-effectiveness analysis.

Abstract

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 (904 US dollars) 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.

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  • Authors+Show Affiliations

    ,

    School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. joyceyou@cuhk.edu.hk

    , ,

    Source

    Alimentary pharmacology & therapeutics 17:6 2003 Mar 15 pg 785-92

    MeSH

    Cost-Benefit Analysis
    Dose-Response Relationship, Drug
    Gastroesophageal Reflux
    Histamine H2 Antagonists
    Humans
    Proton Pump Inhibitors
    Proton Pumps
    Quality-Adjusted Life Years

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12641500

    Citation

    You, J H S., et al. "Low-dose or Standard-dose Proton Pump Inhibitors for Maintenance Therapy of Gastro-oesophageal Reflux Disease: a Cost-effectiveness Analysis." Alimentary Pharmacology & Therapeutics, vol. 17, no. 6, 2003, pp. 785-92.
    You JH, Lee AC, Wong SC, et al. Low-dose or standard-dose proton pump inhibitors for maintenance therapy of gastro-oesophageal reflux disease: a cost-effectiveness analysis. Aliment Pharmacol Ther. 2003;17(6):785-92.
    You, J. H., Lee, A. C., Wong, S. C., & Chan, F. K. (2003). Low-dose or standard-dose proton pump inhibitors for maintenance therapy of gastro-oesophageal reflux disease: a cost-effectiveness analysis. Alimentary Pharmacology & Therapeutics, 17(6), pp. 785-92.
    You JH, et al. Low-dose or Standard-dose Proton Pump Inhibitors for Maintenance Therapy of Gastro-oesophageal Reflux Disease: a Cost-effectiveness Analysis. Aliment Pharmacol Ther. 2003 Mar 15;17(6):785-92. PubMed PMID: 12641500.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Low-dose or standard-dose proton pump inhibitors for maintenance therapy of gastro-oesophageal reflux disease: a cost-effectiveness analysis. AU - You,J H S, AU - Lee,A C M, AU - Wong,S C Y, AU - Chan,F K L, PY - 2003/3/19/pubmed PY - 2003/6/24/medline PY - 2003/3/19/entrez SP - 785 EP - 92 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 17 IS - 6 N2 - 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 (904 US dollars) 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. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/12641500/Low_dose_or_standard_dose_proton_pump_inhibitors_for_maintenance_therapy_of_gastro_oesophageal_reflux_disease:_a_cost_effectiveness_analysis_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0269-2813&date=2003&volume=17&issue=6&spage=785 DB - PRIME DP - Unbound Medicine ER -