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Cost-Effectiveness Analysis of Helicobacter pylori Eradication Therapy for Prevention of Gastric Cancer: A Markov Model

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Abstract

Background

Helicobacter pylori (H. pylori) eradication can reduce the prevalence of gastric cancer. However, whether H. pylori eradication therapy should be performed in infected patients, especially in asymptomatic cases, is still controversial.

Aims

The aims of this study were to determine whether H. pylori screening and eradication could prevent gastric cancer in a cost-effective way, and further whether eradication therapy should be administered to asymptomatic individuals.

Methods

Cost-effectiveness analysis was performed using a Markov model. We established two groups, each with 10,000 hypothetical Chinese individuals at the age of 40 years. Clinical outcomes and cost of H. pylori eradication were compared between the eradication and control groups.

Results

There was a lower morbidity with gastric cancer in the eradication group than in the control group, which was most significant after running the model for 15 years. The eradication group experienced an average of 34.64 quality-adjusted life years (QALYs) per person, and the average cost was US $1706.52 per person. The control group exhibited an average of 32.63 QALYs per person, and the average cost was US $2045.10 per person. The cost-effectiveness analysis showed that eradication saved $1539 per LY per person and $168.45 per QALY per person.

Conclusions

H. pylori screening and eradication therapy effectively reduces the morbidity of gastric cancer and cancer-related costs in asymptomatic infected individuals. Therefore, we believe that H. pylori eradication can prevent gastric cancer in a cost-effective way.

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Acknowledgments

This work was supported by the National Natural Science Foundation of China (81600447, 81400606), Science and Technology plan projects of Zhejiang Province (2015C33102), and Zhejiang Provincial Natural Science Foundation of China (LY17H030004).

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Authors and Affiliations

  1. Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang Province, China

    Yan Han, Tianlian Yan, Han Ma, Xin Yao, Chao Lu, Youming Li & Lan Li

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  1. Yan Han
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  2. Tianlian Yan
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  3. Han Ma
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  4. Xin Yao
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  5. Chao Lu
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  6. Youming Li
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  7. Lan Li
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Contributions

YH and LL planned and conducted the study. YH, TY, HM, CL and XY analyzed and interpreted the data. YH, TY, LL and YL drafted and revised the manuscript. All authors approved the final draft of this manuscript for submission.

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Correspondence to Lan Li.

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Han, Y., Yan, T., Ma, H. et al. Cost-Effectiveness Analysis of Helicobacter pylori Eradication Therapy for Prevention of Gastric Cancer: A Markov Model. Dig Dis Sci 65, 1679–1688 (2020). https://doi.org/10.1007/s10620-019-05910-1

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  • DOI: https://doi.org/10.1007/s10620-019-05910-1

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