Economic perspectives in the management of Helicobacter pylori infections.

Abstract

The infection with Helicobacter pylori contributes to the occurrence of at least four diseases, that is, gastric ulcer, duodenal ulcer, gastric cancer and gastric mucosa-associated lymphoma tissue lymphoma. Many gastroenterologists believe that infection with H. pylori can also result in epigastric symptoms and nonulcer dyspepsia. The health economics of H. pylori infection relates to the cost-benefit relationship of preventing, treating or curing these various conditions through medical measures directed against the infectious organism. In addition, economic analyses have addressed various other aspects of diagnosis and management of patients infected with H. pylori. A minority of analyses were based on real data generated from prospective clinical trials or retrospective analysis of utilization of health care resources, while the majority of studies used economic modeling to predict the influence of various medical measures. The models used mostly decision trees, Markov chains, the declining exponential approximation of life expectancy (DEALE), and the accounting technique of net present value. The following three sections of the present chapter are focused towards the management of the three most common conditions associated with H. pylori, that is, peptic ulcer, gastric cancer, and nonulcer dyspepsia. In a subsequent section we discuss the workup of patients with upper abdominal symptoms and a few other economic issues related to the management of patients infected with H. pylori.KeywordsGastric CancerAntibiotic TherapyPeptic UlcerDuodenal UlcerPylorus InfectionThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.