COST AND QUALITY EFFECTS OF TREATING EROSIVE ESOPHAGITIS - A REEVALUATION

The objective of this study was to re-evaluate the clinical and econom ic effects of common therapies for erosive oesophagitis in the light o f a newly approved treatment regimen. A previously constructed 7-month community practice decision analytical model was revised to include t he latest published data on efficacy and symptomatic outcomes. The ori ginal results of phase I therapy (antacids plus dietary, sleeping and lifestyle changes) alone or combined with ranitidine 150mg bid or omep razole 20mg od were reassessed by adding new clinical data on the effi cacy of and symptomatic response to ranitidine 150mg qid. The same pay ment data used in the first analysis were applied here as well, with t he addition of the US price of ranitidine 150mg qid. The study perspec tive was that of the payer or insurer. Omeprazole-based therapy remain ed a dominant strategy for symptomatic care during the 7-month model. It was 14% less costly per patient, led to 23% fewer symptomatic month s, and had 21% lower cost per symptom-free month than ranitidine 150mg qid, the next best alternative. Evolving treatment strategies necessi tate rapid assessment and reassessment so that clinical practice can r emain current, patients can be assured of the best quality, and insure rs can be aware of treatment cost and budgetary impact given limited r esources in all countries. Only by consistent and continuous re-evalua tion of new or changing medical interventions can clinicians and insur ers adapt patient management to new scientifically derived results. Th is is the best manner by which to meet patients' care needs and the cl inical needs of practitioners, as well as the financial needs of payer s.