ECONOMIC-EVALUATION OF HELICOBACTER-PYLORI ERADICATION FOR THE TREATMENT OF DUODENAL-ULCER DISEASE IN JAPAN - A DECISION-ANALYSIS TO ASSESSERADICATION STRATEGY IN COMPARISON WITH A CONVENTIONAL STRATEGY

To evaluate the socio-economic effects of Helicobacter pylori eradicat ion in the treatment of duodenal ulcer disease in Japan, a clinical de cision analysis was performed to assess H. pylori eradication therapy compared with the conventional strategy of maintenance with histamine- 2 receptor antagonists. A decision tree-based state transition model ( Markov chain approach) implemented to simulate a 5 year period of foll ow up was constructed. The H. pylori eradication strategy was found to be superior to the conventional maintenance strategy with regard to c linical effectiveness and other dimensions of a patient's outcome. Fur thermore, in a long-term perspective, the eradication strategy was les s costly than the maintenance strategy. Helicobacter pylori eradicatio n should be recommended as the first choice treatment of H. pylori-pos itive duodenal ulcer patients. The clinical implication of H. pylori e radication entails an improvement in clinical effectiveness and other dimensions of a patient's outcome and a significant reduction in the c osts of duodenal ulcer treatment. The long-term total costs do not dep end on the initial drug cost of an eradication regimen. Pursuing a hig h eradication rate of H. pylori is essential in improving the patient' s outcome and the cost-effectiveness of treatment.