International Digest

Cost-effectiveness of H. pylori testing

Canadian Medical Association Journal 1996; 155: 429

Source: Greenberg PD, Koch J, Cello JP. Clinical utility and cost effectiveness of Helicobacter pylori testing for patients with duodenal and gastric ulcers. Am J Gastroenterol 1996; 91: 228-32.

Researchers in San Francisco retrospectively analysed the cost-effectiveness of Helicobacter pylori testing by antral biopsy over a 4-year period in 231 patients with endoscopically documented duodenal ulcers. Of the 32% of patients tested by biopsy (at a cost of US$23 175), 75% were found to have H. pylori infection. The authors estimated that the total cost for biopsy in all patients (as recommended by current consensus guidelines) plus that of treating infected patients with bismuth, tetracycline and metronidazole would have been US$77 443, as compared with US$8085 if no patients were tested and all were treated empirically for H. pylori infection. They concluded that since most patients with duodenal ulcer have H. pylori infection, all should be treated empirically to avoid the unnecessary expense of antral biopsy.

| CMAJ August 15, 1996 (vol 155, no 4) |