Cost-effectiveness Analysis Comparing Vonoprazanbased Triple Therapy with Proton Pump Inhibitorbased Therapy in the Treatment of Helicobacter pylori Infection in Thailand

Objective: Helicobacter pylori (H. pylori) infection is one of the leading causes of gastrointestinal diseases such as dyspepsia, peptic ulcers. Thailand has a 45.9% prevalence of the infection and an increasing rate of resistance to clarithromycin, leading to standard treatments being less success...

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Autores principales:	Jadesada Lertsirimunkong, Wiwat Thavornwattanayong, Yosita Napuk, Watcharapong Ajcharoen, Vipavee Chaisitsanguan, Supasuta Wachiranukornkul
Formato:	article
Lenguaje:	EN
Publicado:	Mahidol University 2021
Materias:	Cost-effectiveness Vonoprazen Proton pump inhibitors Levofloxacin Concomitant Helicobacter pylori infection Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/b7d017151aa64bde9b4957197d1762bd
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spelling	oai:doaj.org-article:b7d017151aa64bde9b4957197d1762bd2021-12-01T10:07:40ZCost-effectiveness Analysis Comparing Vonoprazanbased Triple Therapy with Proton Pump Inhibitorbased Therapy in the Treatment of Helicobacter pylori Infection in Thailand10.33192/Smj.2021.1072228-8082https://doaj.org/article/b7d017151aa64bde9b4957197d1762bd2021-12-01T00:00:00Zhttps://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/254579https://doaj.org/toc/2228-8082 Objective: Helicobacter pylori (H. pylori) infection is one of the leading causes of gastrointestinal diseases such as dyspepsia, peptic ulcers. Thailand has a 45.9% prevalence of the infection and an increasing rate of resistance to clarithromycin, leading to standard treatments being less successful. Vonoprazan represents a novel drug offering a new treatment regimen. Although vonoprazan has been available in Thailand since 2019, its cost-effectiveness has not been studied previously. Materials and Methods: This study analysed the cost-effectiveness of vonoprazan-based triple therapy compared with PPI-based therapy, in treating clarithromycin resistant H. pylori, by using the markov model from a societal perspective. Results: The total cost of vonoprazan-based triple therapy, levofloxacin-PPI based triple therapy and concomitant-PPI therapy were 784,932.08 baht, 783,863.65 baht and 783,874.55 baht respectively. The quality-adjusted life years (QALYs) of vonoprazan-based triple therapy, levofloxacin-PPI based triple therapy and concomitant-PPI therapy were 25.1118 years, 25.1147 years and 25.1054 years respectively. The cost-effectiveness ratio (CER) of vonoprazanbased triple therapy, levofloxacin-PPI based triple therapy and concomitant-PPI therapy were 31,257.50 baht/ QALYs, 31,211.35 baht/QALYs and 31,223.34 baht per QALYs respectively. Conclusion: Therefore, levofloxacin-PPI based triple therapy was found to be the most cost-effective regimen and the dominant strategy compared with concomitant-PPI or vonoprazan-based triple therapy. It provided higher QALYs and lower treatment costs. Levofloxacin-PPI based triple therapy should be the first choice of an alternative strategy in treating clarithromycin-resistant H. pylori. The results of this study can be used by policymakers to help inform their decisions. Jadesada LertsirimunkongWiwat ThavornwattanayongYosita NapukWatcharapong AjcharoenVipavee ChaisitsanguanSupasuta WachiranukornkulMahidol UniversityarticleCost-effectivenessVonoprazenProton pump inhibitorsLevofloxacinConcomitantHelicobacter pylori infectionMedicine (General)R5-920ENSiriraj Medical Journal, Vol 73, Iss 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cost-effectiveness Vonoprazen Proton pump inhibitors Levofloxacin Concomitant Helicobacter pylori infection Medicine (General) R5-920
spellingShingle	Cost-effectiveness Vonoprazen Proton pump inhibitors Levofloxacin Concomitant Helicobacter pylori infection Medicine (General) R5-920 Jadesada Lertsirimunkong Wiwat Thavornwattanayong Yosita Napuk Watcharapong Ajcharoen Vipavee Chaisitsanguan Supasuta Wachiranukornkul Cost-effectiveness Analysis Comparing Vonoprazanbased Triple Therapy with Proton Pump Inhibitorbased Therapy in the Treatment of Helicobacter pylori Infection in Thailand
description	Objective: Helicobacter pylori (H. pylori) infection is one of the leading causes of gastrointestinal diseases such as dyspepsia, peptic ulcers. Thailand has a 45.9% prevalence of the infection and an increasing rate of resistance to clarithromycin, leading to standard treatments being less successful. Vonoprazan represents a novel drug offering a new treatment regimen. Although vonoprazan has been available in Thailand since 2019, its cost-effectiveness has not been studied previously. Materials and Methods: This study analysed the cost-effectiveness of vonoprazan-based triple therapy compared with PPI-based therapy, in treating clarithromycin resistant H. pylori, by using the markov model from a societal perspective. Results: The total cost of vonoprazan-based triple therapy, levofloxacin-PPI based triple therapy and concomitant-PPI therapy were 784,932.08 baht, 783,863.65 baht and 783,874.55 baht respectively. The quality-adjusted life years (QALYs) of vonoprazan-based triple therapy, levofloxacin-PPI based triple therapy and concomitant-PPI therapy were 25.1118 years, 25.1147 years and 25.1054 years respectively. The cost-effectiveness ratio (CER) of vonoprazanbased triple therapy, levofloxacin-PPI based triple therapy and concomitant-PPI therapy were 31,257.50 baht/ QALYs, 31,211.35 baht/QALYs and 31,223.34 baht per QALYs respectively. Conclusion: Therefore, levofloxacin-PPI based triple therapy was found to be the most cost-effective regimen and the dominant strategy compared with concomitant-PPI or vonoprazan-based triple therapy. It provided higher QALYs and lower treatment costs. Levofloxacin-PPI based triple therapy should be the first choice of an alternative strategy in treating clarithromycin-resistant H. pylori. The results of this study can be used by policymakers to help inform their decisions.
format	article
author	Jadesada Lertsirimunkong Wiwat Thavornwattanayong Yosita Napuk Watcharapong Ajcharoen Vipavee Chaisitsanguan Supasuta Wachiranukornkul
author_facet	Jadesada Lertsirimunkong Wiwat Thavornwattanayong Yosita Napuk Watcharapong Ajcharoen Vipavee Chaisitsanguan Supasuta Wachiranukornkul
author_sort	Jadesada Lertsirimunkong
title	Cost-effectiveness Analysis Comparing Vonoprazanbased Triple Therapy with Proton Pump Inhibitorbased Therapy in the Treatment of Helicobacter pylori Infection in Thailand
title_short	Cost-effectiveness Analysis Comparing Vonoprazanbased Triple Therapy with Proton Pump Inhibitorbased Therapy in the Treatment of Helicobacter pylori Infection in Thailand
title_full	Cost-effectiveness Analysis Comparing Vonoprazanbased Triple Therapy with Proton Pump Inhibitorbased Therapy in the Treatment of Helicobacter pylori Infection in Thailand
title_fullStr	Cost-effectiveness Analysis Comparing Vonoprazanbased Triple Therapy with Proton Pump Inhibitorbased Therapy in the Treatment of Helicobacter pylori Infection in Thailand
title_full_unstemmed	Cost-effectiveness Analysis Comparing Vonoprazanbased Triple Therapy with Proton Pump Inhibitorbased Therapy in the Treatment of Helicobacter pylori Infection in Thailand
title_sort	cost-effectiveness analysis comparing vonoprazanbased triple therapy with proton pump inhibitorbased therapy in the treatment of helicobacter pylori infection in thailand
publisher	Mahidol University
publishDate	2021
url	https://doaj.org/article/b7d017151aa64bde9b4957197d1762bd
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Cost-effectiveness Analysis Comparing Vonoprazanbased Triple Therapy with Proton Pump Inhibitorbased Therapy in the Treatment of Helicobacter pylori Infection in Thailand

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