PMID- 10724795
OWN - NLM
STAT- MEDLINE
DCOM- 20000211
LR  - 20181113
IS  - 1170-7690 (Print)
IS  - 1170-7690 (Linking)
VI  - 16
IP  - 6
DP  - 1999 Dec
TI  - Economic evaluation of long-term management strategies for erosive oesophagitis.
PG  - 679-97
AB  - OBJECTIVE: To compare the expected costs and outcomes of alternative strategies 
      for the management of patients with erosive oesophagitis. DESIGN: There were 3 
      components to the overall analytic approach. First, a decision model was 
      constructed to compare expected costs and outcomes of 6 management strategies. 
      Second, principles of quantitative literature review and meta-analysis were used 
      to determine probabilities of clinical events (i.e. oesophagitis healing and 
      recurrence). Finally, principles of cost-effectiveness analysis were used to 
      compare treatment alternatives in terms of dominance and incremental cost 
      effectiveness. The viewpoint for the study was that of a provincial government 
      payer for healthcare over a 1-year period. MAIN OUTCOME MEASURES AND RESULTS: 
      Healing rates were significantly higher for proton pump inhibitors (PPI) [p < 
      0.001]. Recurrence rates were significantly higher for intermittent therapy 
      (placebo) and lower for regular dose PPI (p < 0.001). Maintenance prokinetic 
      agent (PA) is dominated (i.e. more costly and less effective) and step-down 
      maintenance PPI is dominated through principles of extended dominance. The 
      'efficient frontier' is represented by: maintenance H2-receptor antagonist 
      (H2RA), intermittent PPI, step-down maintenance H2RA and maintenance PPI. 
      CONCLUSIONS: The price of H2RA is a key factor influencing whether step-down 
      maintenance PPI forms part of, or is contained within, the 'efficient frontier' 
      of long term management for erosive oesophagitis.
FAU - Goeree, R
AU  - Goeree R
AD  - Department of Clinical Epidemiology and Biostatistics, McMaster University, 
      Hamilton, Ontario, Canada. goereer@fhs.csu.mcmaster.ca
FAU - O'Brien, B
AU  - O'Brien B
FAU - Hunt, R
AU  - Hunt R
FAU - Blackhouse, G
AU  - Blackhouse G
FAU - Willan, A
AU  - Willan A
FAU - Watson, J
AU  - Watson J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - New Zealand
TA  - Pharmacoeconomics
JT  - PharmacoEconomics
JID - 9212404
RN  - 0 (Gastrointestinal Agents)
RN  - 0 (Proton Pump Inhibitors)
MH  - Costs and Cost Analysis
MH  - Esophagitis/*economics/*therapy
MH  - Gastrointestinal Agents/economics/therapeutic use
MH  - Humans
MH  - Long-Term Care
MH  - Proton Pump Inhibitors
MH  - Treatment Outcome
EDAT- 2000/03/21 00:00
MHDA- 2000/03/21 00:01
CRDT- 2000/03/21 00:00
PHST- 2000/03/21 00:00 [pubmed]
PHST- 2000/03/21 00:01 [medline]
PHST- 2000/03/21 00:00 [entrez]
AID - 10.2165/00019053-199916060-00007 [doi]
PST - ppublish
SO  - Pharmacoeconomics. 1999 Dec;16(6):679-97. doi: 10.2165/00019053-199916060-00007.