Abstract
Helicobacter pylori (Hp) management has undoubtedly resulted in a notable economic burden on healthcare systems globally, including Greece. Its cost has never been estimated so far, especially during the recent 10-year unprecedented financial crisis. Direct medical and procedural costs for one attempt “outpatient” Hp eradication treatment were estimated as the following: (I) first-line regimens: 10 and 14 days standard triple, 10 and 14 days sequential, 10 and 14 days concomitant non-bismuth quadruple, 14 days hybrid, (II) second-line salvage regimens: 10 and 14 days levofloxacin-containing triple regimens. Treatment costs using prototypes and/or generic drugs were calculated. Drug prices were collected and confirmed from two official online medical databases including all medicines approved by the Greek National Organization for Medicines. Regimens based on generics were more affordable than prototypes and those including pantoprazole yielded the lowest prices (mean: 27.84 €). Paradoxically, 10-day concomitant and 14-day hybrid regimens (currently providing good (90–94%) first-line eradication rates in Greece) cost the same (mean: 34.76 €). The expenditures for Hp eradication treatment regimens were estimated thoroughly for the first time in Greece. These data should be taken into account by Public Health policymakers both in Greece and the European Union, aiming for a better and less expensive therapeutic approach.
Highlights
Greece has been experiencing a financial decline during the last decade, which is a recognizable representative of the global crisis, and the resultant austerity policies have affected national healthcare expenditures [1,2]
Helicobacter pylori infection (Hp-I) affects 40.2–64.0% of the Greek population, following the global prevalence and an increasing tendency of infectious diseases in our country attributed to economic hardships and migratory flows [6,7,8,9]
A wide spectrum of potential Hp eradication treatment regimens were included in our survey (Figure 2):
Summary
Greece has been experiencing a financial decline during the last decade, which is a recognizable representative of the global crisis, and the resultant austerity policies have affected national healthcare expenditures [1,2]. A 35% reduction in the National Health System resources was noted between the onset of the crisis and 2016; concurrently, spending for health was among the lowest in Europe [3]. This reduction, at least at the beginning, did not affect medication costs, a fact that is quite obvious considering that in 2013, proton pump inhibitors (PPIs) in Greece were among the most expensive drugs compared to other European countries (similar to Switzerland) [4]. Insulin resistance, non-alcoholic liver disease, and neurodegenerative conditions have been associated with Hp-I [10,11,12,13,14,15,16]
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