Pharmacoeconomic Comparison of Treatments for the Eradication of Helicobacter pylori in Enugu State, Nigeria

This study aimed at describing the cost-effectiveness of four regimen commonly employed in Enugu State, Nigeria for eradicating Helicobacter pylori. Adecision analysis model was constructed to represent the strategies used in eradication of H. pylori in most practice setting in Enugu State. Each of the four strategies was hypothesized to have been administered to a cohort of 100 patients. Cost of medication was the only cost component included and were based on 2007 prices. Base estimates for eradication of H. pylori with omeprazole, clarithromycin and metronidazole (OCM), omeprazole, amoxicillin and metronidazole (OAM), and re-treatment with OCM were obtained from an earlier published study. The average cost-effectiveness ratio was determined. Incremental costs of the strategy with highest effectiveness in relation to other strategies were also calculated. The unit of comparison for evaluating cost-effectiveness was the number of years it would take for the cumulative future cost of treating a patient with relapse treatment, to equal the incremental cost of the most effective eradication therapy. The use of OAM in eradication of H. pylori in patients with duodenal ulcer and re-treating with OCM in patients that still shows dyspeptic symptoms is the most cost-effective option compared to the other three strategies.