An Economic Evaluation of Family-Based Versus Traditional Helicobacter pylori Screen-and-Treat Strategy: Based on Real-World Data and Microsimulation Model

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2024-08-07 DOI:10.1111/hel.13123

Yue Ma, Xianzhu Zhou, Yashi Liu, Shihan Xu, Aixia Ma, Yiqi Du, Hongchao Li

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引用次数: 0

Abstract

Objective

There is an economic evaluation on the family-based Helicobacter pylori screen-and-treat strategy (FBHS) in China. This study aimed to compare the cost-effectiveness of the FBHS with the traditional H. pylori screen-and-treat strategy (TBHS).

Materials and Methods

A seven-state microsimulation model, including H. pylori infection and gastric cancer states, was constructed on the basis of the target family samples from 29 provinces in China. Taking a lifetime horizon from a healthcare system perspective, the long-term costs and health outcomes of the FBHS and TBHS screening strategies were simulated separately, and economic evaluations were performed. The model parameters were primarily derived from real-world data, published literature, and expert opinions. The primary outcome was the incremental cost-effectiveness ratio (ICER) expressed as cost/quality-adjusted life-year (QALY) gained. One-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analysis were performed to assess the uncertainty of the results.

Results

The base-case analysis revealed that the average costs for FBHS and TBHS were 563.67 CNY and 574.08 CNY, respectively, with corresponding average QALYs of 14.83 and 14.79. The ICER for the comparison between the two strategies was −214.07, indicating that FBHS was an absolutely dominant strategy with better cost-effectiveness. The results of both one-way sensitivity analysis and probabilistic sensitivity analysis were robust. When taking into account the added benefit of the higher H. pylori eradication rate in FBHS, the average costs were further reduced, and the average QALYs were increased, solidifying its position as an unequivocally dominant strategy.

Conclusion

The FBHS is an absolutely dominant and cost-effective strategy that enables an optimized allocation of screening resources. Decision-makers should prioritize FBHS when developing H. pylori prevention and control strategies.

查看原文本刊更多论文

基于家庭与传统幽门螺旋杆菌筛查与治疗策略的经济评估：基于真实世界数据和微观模拟模型。

目的：中国对基于家庭的幽门螺杆菌筛查和治疗策略（FBHS）进行了经济评估。本研究旨在比较家庭幽门螺杆菌筛查和治疗策略（FBHS）与传统幽门螺杆菌筛查和治疗策略（TBHS）的成本效益：以中国 29 个省的目标家庭样本为基础，构建了包括幽门螺杆菌感染和胃癌状态在内的七状态微观模拟模型。从医疗系统的角度出发，以一生为周期，分别模拟了FBHS和TBHS筛查策略的长期成本和健康结果，并进行了经济评价。模型参数主要来源于实际数据、已发表文献和专家意见。主要结果是以成本/质量调整生命年（QALY）表示的增量成本效益比（ICER）。为评估结果的不确定性，进行了单向敏感性分析、概率敏感性分析和情景分析：基础病例分析显示，FBHS 和 TBHS 的平均成本分别为 563.67 元和 574.08 元，相应的平均 QALY 分别为 14.83 和 14.79。两种策略比较的 ICER 为-214.07，表明 FBHS 是一种绝对优势策略，具有更好的成本效益。单向敏感性分析和概率敏感性分析的结果都很稳健。如果考虑到 FBHS 更高的幽门螺杆菌根除率所带来的额外益处，平均成本将进一步降低，平均 QALYs 将进一步提高，从而巩固其绝对主导策略的地位：结论：FBHS 是一种具有绝对优势和成本效益的策略，能够优化筛查资源的分配。决策者在制定幽门螺杆菌预防和控制策略时应优先考虑 FBHS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.