COST-EFFECTIVENESS MODELING OF VARIOUS ST RATEGIES FOR THE ERADICATION OF HELICOBACTER-PYLORI IN DUODENAL-ULCER TREATMENT

We propose a Markov modelling of eight different therapeutic protocols used in the eradication of Helicobacter pylori (Hp) on ulcer patients who have been diagnosed Hp positive. Multitherapies use either amoxyc illin (A), clarithromycin (C) or metronidazole (M) in association with one of two antisecretory drugs, omeprazole (O) or ranitidine (R). The eradication rates retained as central hypotheses are those put forth by Cayla according to calculations based on published and validated tr ials (Conference consensus Paris, 1995). The therapies studied are as follows: two bitherapies (OA and OC) taken for 14 days and six trither apies: RAM (12 days), OAM (7 days), RAC (7 days), OAC (7 days), RCM (7 days) and OCM (7 days). The Markov model simulates a Hp positive ulce r patient's future over two years. Results confirm that 1) tritherapie s are more cost-effective than bitherapies, and 2) differences in trit herapy eradication rates depend on resistance to antibiotics.