Skip to main content
Erschienen in: PharmacoEconomics 4/2002

01.04.2002 | Original Research Article

Cost Effectiveness of Esomeprazole Compared with Omeprazole in the Acute Treatment of Patients with Reflux Oesophagitis in the UK

verfasst von: Peter Wahlqvist, Ola Junghard, Andy Higgins, Jonathan Green

Erschienen in: PharmacoEconomics | Ausgabe 4/2002

Einloggen, um Zugang zu erhalten

Abstract

Background: Clinical studies have demonstrated that esomeprazole is superior to omeprazole for the acute treatment of reflux oesophagitis.
Objective: To compare the cost effectiveness of esomeprazole 40mg once daily with omeprazole 20mg once daily in patients with reflux oesophagitis.
Methods: Pooled data were used from three 8-week clinical trials comparing the efficacy and safety of esomeprazole 40mg once daily and omeprazole 20mg once daily for the acute treatment of reflux oesophagitis. A simple decision analysis model, using UK direct medical costs, compared the cost effectiveness of the two treatments. Healing probabilities derived from the clinical studies using the Life Table method were used to estimate the effectiveness and cost of treating 100 patients with reflux oesophagitis. Patient management assumptions were based on a clinical management survey involving 25 UK physicians.
Perspective: UK National Health Service.
Results: After 4 weeks’ therapy, the Life Table estimated the oesophageal healing rate to be 77.7% in esomeprazole 40mg once-daily recipients (n = 2446), compared with 67.6% in omeprazole 20mg once-daily recipients (n = 2431; p < 0.001). The corresponding values after 8 weeks’ treatment were 93.4% and 86.2%, respectively (p < 0.001). The model predicted that when considering healing probabilities over 8 weeks, esomeprazole 40mg once daily produced total direct cost savings of £1290 (14%) when compared with omeprazole 20mg once daily. When considering the cost of treating patients who had failed treatment (defined as patient not healed as assessed by endoscopy) after 8 weeks, the cost advantage for esomeprazole was even greater.
Conclusion: Esomeprazole 40mg once daily is cost effective compared with omeprazole 20mg once daily in the acute treatment of patients with reflux oesophagitis; esomeprazole provides greater effectiveness at a lower cost.
Literatur
1.
Zurück zum Zitat National Institute for Clinical Excellence 2000. Guidance on the use of Proton Pump Inhibitors (PPIs) in the treatment of dyspepsia [online]. Available from URL: http://www.nice.org.uk [Accessed 2002, Mar 20] National Institute for Clinical Excellence 2000. Guidance on the use of Proton Pump Inhibitors (PPIs) in the treatment of dyspepsia [online]. Available from URL: http://​www.​nice.​org.​uk [Accessed 2002, Mar 20]
2.
Zurück zum Zitat Spechler SJ. Epidemiology and natural history of gastro-oesophageal reflux disease. Digestion 1992; 51 Suppl. 1: 24–9PubMedCrossRef Spechler SJ. Epidemiology and natural history of gastro-oesophageal reflux disease. Digestion 1992; 51 Suppl. 1: 24–9PubMedCrossRef
3.
Zurück zum Zitat Jones R. Gastro-oesophageal reflux disease in general practice. Scand J Gastroenterol 1995; 30 Suppl. 211: 35–8CrossRef Jones R. Gastro-oesophageal reflux disease in general practice. Scand J Gastroenterol 1995; 30 Suppl. 211: 35–8CrossRef
4.
Zurück zum Zitat Bate CM, Green JR, Axon AT, et al. Omeprazole is more effective than cimetidine for the relief of all grades of gastro-oesophageal reflux disease-associated heartburn, irrespective of the presence or absence of endoscopic oesophagitis. Aliment Pharmacol Ther 1997; 11: 755–63PubMedCrossRef Bate CM, Green JR, Axon AT, et al. Omeprazole is more effective than cimetidine for the relief of all grades of gastro-oesophageal reflux disease-associated heartburn, irrespective of the presence or absence of endoscopic oesophagitis. Aliment Pharmacol Ther 1997; 11: 755–63PubMedCrossRef
5.
Zurück zum Zitat Venables TL, Newland RD, Patel AC, et al. Omeprazole 10 milligrams once daily, omeprazole 20 milligrams once daily, or ranitidine 150 milligrams twice daily evaluated as initial therapy for the relief of symptoms of gastro-oesophageal reflux disease in general practice. Scand J Gastroenterol 1997; 32: 965–73PubMedCrossRef Venables TL, Newland RD, Patel AC, et al. Omeprazole 10 milligrams once daily, omeprazole 20 milligrams once daily, or ranitidine 150 milligrams twice daily evaluated as initial therapy for the relief of symptoms of gastro-oesophageal reflux disease in general practice. Scand J Gastroenterol 1997; 32: 965–73PubMedCrossRef
6.
Zurück zum Zitat Carlsson R, Dent J, Watts R, et al. Gastro-oesophageal reflux disease in primary care: an international study of different treatment strategies with omeprazole. International GORD Study Group. Eur J Gastroenterol Hepatol 1998; 10: 119–24PubMedCrossRef Carlsson R, Dent J, Watts R, et al. Gastro-oesophageal reflux disease in primary care: an international study of different treatment strategies with omeprazole. International GORD Study Group. Eur J Gastroenterol Hepatol 1998; 10: 119–24PubMedCrossRef
7.
Zurück zum Zitat Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999; 45: 172–80PubMedCrossRef Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999; 45: 172–80PubMedCrossRef
8.
Zurück zum Zitat Castell DO, Richter JE, Robinson M, et al. Efficacy and safety of lansoprazole in the treatment of erosive reflux oesophagitis. Am J Gastroenterol 1996; 91: 1749–57PubMed Castell DO, Richter JE, Robinson M, et al. Efficacy and safety of lansoprazole in the treatment of erosive reflux oesophagitis. Am J Gastroenterol 1996; 91: 1749–57PubMed
9.
Zurück zum Zitat Corinaldesi R, Valentini M, Belaïche J, et al. Pantoprazole and omeprazole in the treatment of reflux esophagitis: a European multicentre study. Aliment Pharmacol Ther 1995; 9: 667–71PubMedCrossRef Corinaldesi R, Valentini M, Belaïche J, et al. Pantoprazole and omeprazole in the treatment of reflux esophagitis: a European multicentre study. Aliment Pharmacol Ther 1995; 9: 667–71PubMedCrossRef
10.
Zurück zum Zitat Hallerbäck B, Unge P, Carling L, et al. Omeprazole or ranitidine in long-term treatment of reflux esophagitis. Gastroenterology 1994; 107: 1305–11PubMed Hallerbäck B, Unge P, Carling L, et al. Omeprazole or ranitidine in long-term treatment of reflux esophagitis. Gastroenterology 1994; 107: 1305–11PubMed
11.
Zurück zum Zitat Hatlebakk JC, Berstad A. Lansoprazole 15 and 30mg daily in maintaining healing and symptom relief in patients with reflux oesophagitis. Aliment Pharmacol Ther 1997; 11 (2): 365–72CrossRef Hatlebakk JC, Berstad A. Lansoprazole 15 and 30mg daily in maintaining healing and symptom relief in patients with reflux oesophagitis. Aliment Pharmacol Ther 1997; 11 (2): 365–72CrossRef
12.
Zurück zum Zitat Mössner J, Holscher AH, Herz R, et al. A double-blind study of pantoprazole and omeprazole in the treatment of reflux esophagitis: a multicentre trial. Aliment Pharmacol Ther 1995; 9: 321–6PubMedCrossRef Mössner J, Holscher AH, Herz R, et al. A double-blind study of pantoprazole and omeprazole in the treatment of reflux esophagitis: a multicentre trial. Aliment Pharmacol Ther 1995; 9: 321–6PubMedCrossRef
13.
Zurück zum Zitat Mulder CJ, Dekker W, Gerretsen M. Lansoprazole 30mg versus omeprazole 40mg in the treatment of reflux oesophagitis grade II, III and IVA (a Dutch multicentre trial). Eur J Gastroenterol Hepatol 1996; 8: 1101–6PubMedCrossRef Mulder CJ, Dekker W, Gerretsen M. Lansoprazole 30mg versus omeprazole 40mg in the treatment of reflux oesophagitis grade II, III and IVA (a Dutch multicentre trial). Eur J Gastroenterol Hepatol 1996; 8: 1101–6PubMedCrossRef
14.
Zurück zum Zitat Goeree R, O’Brien B, Hunt R, et al. Economic evaluation of long-term management strategies for erosive oesophagitis. Pharmacoeconomics 1999; 16: 679–97PubMedCrossRef Goeree R, O’Brien B, Hunt R, et al. Economic evaluation of long-term management strategies for erosive oesophagitis. Pharmacoeconomics 1999; 16: 679–97PubMedCrossRef
15.
Zurück zum Zitat Dent J, Jones R, Kahrilas P, et al. Management of gastro-oesophageal reflux disease in general practice. BMJ 2001; 322: 344–7PubMedCrossRef Dent J, Jones R, Kahrilas P, et al. Management of gastro-oesophageal reflux disease in general practice. BMJ 2001; 322: 344–7PubMedCrossRef
16.
Zurück zum Zitat Dent J, Brun J, Fendrick AM, on behalf of the General Workshop Group, et al. An evidence-based appraisal of reflux disease management: The General Workshop Report. Gut 1999; 44 Suppl. 2: S1–16CrossRef Dent J, Brun J, Fendrick AM, on behalf of the General Workshop Group, et al. An evidence-based appraisal of reflux disease management: The General Workshop Report. Gut 1999; 44 Suppl. 2: S1–16CrossRef
17.
Zurück zum Zitat Röhss K, Wilder-Smith CH, Claar-Nilsson C, et al. Esomeprazole 40 mg provides more effective acid control that standard doses of all other proton pump inhibitors [abstract]. Gastroenterology 2001; 120: A419 Röhss K, Wilder-Smith CH, Claar-Nilsson C, et al. Esomeprazole 40 mg provides more effective acid control that standard doses of all other proton pump inhibitors [abstract]. Gastroenterology 2001; 120: A419
18.
Zurück zum Zitat Kahrilas PJ, Falk GW, Johnson DA, et al. Esomeprazole improves healing and symptom resolution as compared with omeprazole in reflux oesophagitis patients: a randomised controlled trial. Aliment Pharmacol Ther 2000; 14 (10): 1249-58PubMedCrossRef Kahrilas PJ, Falk GW, Johnson DA, et al. Esomeprazole improves healing and symptom resolution as compared with omeprazole in reflux oesophagitis patients: a randomised controlled trial. Aliment Pharmacol Ther 2000; 14 (10): 1249-58PubMedCrossRef
19.
Zurück zum Zitat Richter JE, Kahrilas PJ, Johanson J, et al. Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: a randomized controlled trial. Am J Gastroenterol 2001; 96: 656–65PubMedCrossRef Richter JE, Kahrilas PJ, Johanson J, et al. Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: a randomized controlled trial. Am J Gastroenterol 2001; 96: 656–65PubMedCrossRef
20.
Zurück zum Zitat Läkemedelsmonografier -Nexium (esomeprazol). Information från Läkemedelsverket 2000; 11 (5): 73–6. Läkemedelsmonografier -Nexium (esomeprazol). Information från Läkemedelsverket 2000; 11 (5): 73–6.
21.
Zurück zum Zitat Wesley D. Life Table analysis. J InsurMed 1998; 30 (4): 247–54 Wesley D. Life Table analysis. J InsurMed 1998; 30 (4): 247–54
22.
Zurück zum Zitat Netten A, Dennett J. Unit costs of health and social care 1998. Canterbury: Personal Social Services Research Unit, University of Kent, 1999 Netten A, Dennett J. Unit costs of health and social care 1998. Canterbury: Personal Social Services Research Unit, University of Kent, 1999
23.
Zurück zum Zitat Cambridge Health Database 1998. Cambridge Pharma Consultancy. Cambridge Health Database 1998. Cambridge Pharma Consultancy.
24.
Zurück zum Zitat MIMS (Monthly Index of Medical Specialities). London: Haymarket Medical Ltd., 2000 Oct MIMS (Monthly Index of Medical Specialities). London: Haymarket Medical Ltd., 2000 Oct
25.
Zurück zum Zitat Wahlqvist P, Higgins A, Green J. Management of GORD in the UK: results of a survey. Eur J Intern Med 2001; 12: A273–4 Wahlqvist P, Higgins A, Green J. Management of GORD in the UK: results of a survey. Eur J Intern Med 2001; 12: A273–4
26.
Zurück zum Zitat Bate CM. Cost effectiveness of omeprazole in the treatment of reflux oesophagitis. Br J Med Econ 1991; 1: 53–61 Bate CM. Cost effectiveness of omeprazole in the treatment of reflux oesophagitis. Br J Med Econ 1991; 1: 53–61
27.
Zurück zum Zitat Bate CM, Richardson PDI. A one year model for the cost effectiveness of treating reflux esophagitis. Br J Med Econ 1992; 2: 5–11 Bate CM, Richardson PDI. A one year model for the cost effectiveness of treating reflux esophagitis. Br J Med Econ 1992; 2: 5–11
28.
Zurück zum Zitat Crawley JA, Schmitt CM. How satisfied are chronic heartburn sufferers with their prescription medications? Results of the Patient Unmet Needs Survey. J Clin Outcomes Management 2000; 7: 29–34 Crawley JA, Schmitt CM. How satisfied are chronic heartburn sufferers with their prescription medications? Results of the Patient Unmet Needs Survey. J Clin Outcomes Management 2000; 7: 29–34
29.
Zurück zum Zitat Revicki DA, Wood M, Maton PN, et al. The impact of gastrooesophageal reflux disease on health-related quality of life. Am J Med 1998; 104: 252–8PubMedCrossRef Revicki DA, Wood M, Maton PN, et al. The impact of gastrooesophageal reflux disease on health-related quality of life. Am J Med 1998; 104: 252–8PubMedCrossRef
30.
Zurück zum Zitat Rush DR, Stelmach WJ, Young TL, et al. Clinical effectiveness and quality of life with ranitidine vs placebo in gastrooesophageal reflux disease patients: a clinical experience network (CEN) study. J Fam Pract 1995; 41: 126–36PubMed Rush DR, Stelmach WJ, Young TL, et al. Clinical effectiveness and quality of life with ranitidine vs placebo in gastrooesophageal reflux disease patients: a clinical experience network (CEN) study. J Fam Pract 1995; 41: 126–36PubMed
31.
Zurück zum Zitat Wiklund I, Bardhan KD, Müller-Lissner S, et al. Quality of life during acute and intermittent treatment of gastro-oesophageal reflux disease with omeprazole compared with ranitidine: results from a multi-center clinical trial. Ital J Gastroenterol Hepatol 1998; 30: 19–27PubMed Wiklund I, Bardhan KD, Müller-Lissner S, et al. Quality of life during acute and intermittent treatment of gastro-oesophageal reflux disease with omeprazole compared with ranitidine: results from a multi-center clinical trial. Ital J Gastroenterol Hepatol 1998; 30: 19–27PubMed
32.
Zurück zum Zitat Henke CJ, Levin TR, Henning JM, et al. Work loss costs due to peptic ulcer disease and gastroesophageal reflux disease in a health maintenance organisation. Am J Gastroenterol 2000; 95: 788–92PubMedCrossRef Henke CJ, Levin TR, Henning JM, et al. Work loss costs due to peptic ulcer disease and gastroesophageal reflux disease in a health maintenance organisation. Am J Gastroenterol 2000; 95: 788–92PubMedCrossRef
33.
Zurück zum Zitat Wahlqvist P, Carlsson J, Stålhammar N-O, et al. Validity of a work productivity and activity impairment questionnaire for patients with symptoms of gastro-esophageal reflux disease (WPAI-GERD): results from a cross-sectional study. Value Health 2002; 5: 106–13PubMedCrossRef Wahlqvist P, Carlsson J, Stålhammar N-O, et al. Validity of a work productivity and activity impairment questionnaire for patients with symptoms of gastro-esophageal reflux disease (WPAI-GERD): results from a cross-sectional study. Value Health 2002; 5: 106–13PubMedCrossRef
Metadaten
Titel
Cost Effectiveness of Esomeprazole Compared with Omeprazole in the Acute Treatment of Patients with Reflux Oesophagitis in the UK
verfasst von
Peter Wahlqvist
Ola Junghard
Andy Higgins
Jonathan Green
Publikationsdatum
01.04.2002
Verlag
Springer International Publishing
Erschienen in
PharmacoEconomics / Ausgabe 4/2002
Print ISSN: 1170-7690
Elektronische ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200220040-00006

Weitere Artikel der Ausgabe 4/2002

PharmacoEconomics 4/2002 Zur Ausgabe

Review Article

Enoxaparin