PMID- 31178490
OWN - NLM
STAT- MEDLINE
DCOM- 20191219
LR  - 20200225
IS  - 1349-7235 (Electronic)
IS  - 0918-2918 (Print)
IS  - 0918-2918 (Linking)
VI  - 58
IP  - 17
DP  - 2019 Sep 1
TI  - Vonoprazan versus Lansoprazole for the Initial Treatment of Reflux Esophagitis: A 
      Cost-effectiveness Analysis in Japan.
PG  - 2427-2433
LID - 10.2169/internalmedicine.2535-18 [doi]
AB  - Objective Gastroesophageal reflux disease (GERD) is a highly prevalent disorder 
      that negatively affects patients' quality of life and reduces their work 
      productivity. The medical expenses associated with the treatment of GERD are the 
      highest among all digestive diseases. Current guidelines recommend the 
      administration of a standard dose of proton pump inhibitor (PPI) for eight weeks 
      as an initial GERD treatment. However, there is growing concern regarding the 
      safety of PPI treatment. Recently, a novel potassium-competitive acid blocker 
      (P-CAB), vonoprazan (VPZ), was approved for the treatment of reflux esophagitis 
      in Japan and may provide clinical benefits in GERD treatment. This study was 
      conducted to evaluate the cost-effectiveness of a P-CAB, VPZ vs. a PPI, 
      lansoprazole (LPZ), for the acute medical treatment of reflux esophagitis. 
      Methods A clinical decision analysis was performed using a Markov chain approach 
      to compare VPZ to LPZ in the acute treatment of reflux esophagitis in Japan. 
      Results The P-CAB strategy was superior to the PPI strategy in terms of 
      cost-effectiveness (direct cost per patient to achieve clinical success) and the 
      number of days for which medication was required. Sensitivity analyses revealed 
      that this superiority was robust within the plausible range of probabilities. 
      This remained true even when the healing rates in cases of mild esophagitis were 
      applied. Conclusion The P-CAB strategy was consistently superior to the 
      conventional PPI strategy using the original LPZ in terms of cost-effectiveness 
      and the number of days for which medication was required. Thus, VPZ appears to be 
      the drug of choice for the acute medical treatment of reflux esophagitis.
FAU - Habu, Yasuki
AU  - Habu Y
AD  - Department of Gastroenterology, Saiseikai-Noe Hospital, Japan.
LA  - eng
PT  - Journal Article
DEP - 20190607
PL  - Japan
TA  - Intern Med
JT  - Internal medicine (Tokyo, Japan)
JID - 9204241
RN  - 0 
      (1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine)
RN  - 0 (Gastrointestinal Agents)
RN  - 0 (Pyrroles)
RN  - 0 (Sulfonamides)
RN  - 0K5C5T2QPG (Lansoprazole)
SB  - IM
MH  - Adult
MH  - Cost-Benefit Analysis
MH  - Drug Administration Schedule
MH  - Female
MH  - Gastroesophageal Reflux/*drug therapy
MH  - Gastrointestinal Agents/administration & dosage/economics/*therapeutic use
MH  - Humans
MH  - Japan
MH  - Lansoprazole/administration & dosage/economics/*therapeutic use
MH  - Markov Chains
MH  - Pyrroles/administration & dosage/economics/*therapeutic use
MH  - Quality of Life
MH  - Sulfonamides/administration & dosage/economics/*therapeutic use
PMC - PMC6761357
OTO - NOTNLM
OT  - cost-effectiveness
OT  - gastroesophageal reflux disease
OT  - potassium-competitive acid blocker
OT  - proton pump inhibitor
OT  - reflux esophagitis
OT  - vonoprazan
COIS- The author states that he has no Conflict of Interest (COI).
EDAT- 2019/06/11 06:00
MHDA- 2019/12/20 06:00
PMCR- 2019/09/01
CRDT- 2019/06/11 06:00
PHST- 2019/06/11 06:00 [pubmed]
PHST- 2019/12/20 06:00 [medline]
PHST- 2019/06/11 06:00 [entrez]
PHST- 2019/09/01 00:00 [pmc-release]
AID - 10.2169/internalmedicine.2535-18 [doi]
PST - ppublish
SO  - Intern Med. 2019 Sep 1;58(17):2427-2433. doi: 10.2169/internalmedicine.2535-18. 
      Epub 2019 Jun 7.