4463 : SYSTEMATIC REVIEW AND ECONOMIC EVALUATION OF HELICOBACTER PYLORI ERADICATION TREATMENT FOR NON-ULCER DYSPEPSIA

Author(s): 
Osonnaya, Comfort; Osonnaya, Kingsley; Sanderson, Ian; Swain, Paul
Text: 
Oral Presentation
Research Based
OBJECTIVE: To evaluate efficacy and cost effectiveness of Helicobacter pylori eradication treatment in patients with non- ulcer dyspepsia infected with H pylori.
METHOD: Seven electronic databases were searched for randomised controlled trials from January 1966 to April 2004. Experts in the field, pharmaceutical companies, and journals were contacted for information on any unpublished trails. Trials reports were reviewed according to predefined eligibility and equality criteria. Systematic review of randomised controlled trials comparing H pylori eradication with placebo or another drug treatment was carried out. Results were incorporated into a Markov model comparing health service costs and benefits of H pylori eradication with antacid treatment over one year.
MAIN OUTCOME MEASURES: Relatives risk reduction for remaining dyspeptic symptoms (the same or worse) at 3 to-12 months. Cost per dyspepsia-free month estimated from Markov model based on estimated relative risk reduction.
RESULTS: Thirty two trials were included in the systematic review, 24 of which evaluated dyspepsia at 3 to 12 month in a total of 6776 patients. H pylori eradication treatment was significantly superior to placebo in treatment non-ulcer dyspepsia (relative risk reduction; 9%, 95% confidence interval; 4% to 14%), one case of dyspepsia being cured for every 15 people treated. H pylori eradication cost £58 per dyspepsia-free month during first year of treatment.
CONCLUSION: H pylori eradication may be a cost effective treatment for non-ulcer dyspepsia in infected patients but further evidence is needed for decision makers' willingness to pay for relief of dyspepsia.
Topic: Clinical Practice