Pritchard, D Mark 
ORCID: 0000-0001-7971-3561, Bornschein, Jan, Beales, Ian, Beresniak, Ariel, Salhi, Hocine and Malfertheiner, Peter
(2021)
Cost-effectiveness modelling of use of urea breath test for the management of <i>Helicobacter pylori</i>-related dyspepsia and peptic ulcer in the UK.
BMJ OPEN GASTROENTEROLOGY, 8 (1).
e000685-.
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Abstract
<h4>Objective</h4>Clinical data comparing diagnostic strategies in the management of <i>Helicobacter pylori</i>-associated diseases are limited. Invasive and noninvasive diagnostic tests for detecting <i>H. pylori</i> infection are used in the clinical care of patients with dyspeptic symptoms. Modelling studies might help to identify the most cost-effective strategies. The objective of the study is to assess the cost-effectiveness of a 'test-and-treat' strategy with the urea breath test (UBT) compared with other strategies, in managing patients with <i>H. pylori</i>-associated dyspepsia and preventing peptic ulcer in the UK.<h4>Design</h4>Cost-effectiveness models compared four strategies: 'test-and-treat' with either UBT or faecal antigen test (FAT), 'endoscopy-based strategy' and 'symptomatic treatment'. A probabilistic cost-effectiveness analysis was performed using a simulation model in order to identify probabilities and costs associated with relief of dyspepsia symptoms (over a 4-week time horizon) and with prevention of peptic ulcers (over a 10-year time horizon). Clinical and cost inputs to the model were derived from routine medical practice in the UK.<h4>Results</h4>For relief of dyspepsia symptoms, 'test-and-treat' strategies with either UBT (€526/success) and FAT (€518/success) were the most cost-effective strategies compared with 'endoscopy-based strategy' (€1317/success) and 'symptomatic treatment' (€1 029/success). For the prevention of peptic ulcers, 'test-and-treat' strategies with either UBT (€208/ulcer avoided/year) or FAT (€191/ulcer avoided/year) were the most cost-effective strategies compared with 'endoscopy-based strategy' (€717/ulcer avoided/year) and 'symptomatic treatment' (€651/ulcer avoided/year) (1 EUR=0,871487 GBP at the time of the study).<h4>Conclusion</h4>'Test-and-treat' strategies with either UBT or FAT are the most cost-effective medical approaches for the management of <i>H. pylori</i>-associated dyspepsia and the prevention of peptic ulcer in the UK. A 'test-and-treat' strategy with UBT has comparable cost-effectiveness outcomes to the current standard of care using FAT in the UK.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | dyspepsia, 13c-urea breath test, Helicobacter pylori, cancer, gastric and duodenal ulcers |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 16 Jul 2021 10:03 |
| Last Modified: | 26 Jan 2024 06:12 |
| DOI: | 10.1136/bmjgast-2021-000685 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3130256 |
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