Eradicating Helicobacter pylori in proton pump inhibitor-users saves money

▆ Mason JMM, Raghunath AS, Hungin APS, et al. Helicobacter pylori eradication in long-term proton pump inhibitor users is highly cost-effective: economic analysis of the HELPUP trial. Aliment Pharmacol Ther 2008;28:1297–1303.

Eradicating Helicobacter pylori (H pylori), if present, has been shown to be a cost-effective management strategy for both peptic ulcer disease and functional dyspepsia. There is also evidence that this approach saves money long-term if adopted in the general population. Now Mason and colleagues report data from subjects in primary care requiring long-term proton pump inhibitors (PPIs) over a 2-year study period. In this elegant placebo-controlled trial, long-term PPI users were screened for H pylori with carbon-urea breath testing, and randomised to receive either eradication therapy (PPI plus amoxicillin and clarithromycin for 1 week) or identical-appearing placebos. The authors collected data on gastrointestinal symptom-related health services resource use prospectively, and applied unit costs from NHS sources to these data to compare mean costs between the two arms of the trial at 2 years. Costs for subsequent PPI prescribing, dyspepsia-related consultations and endoscopies were all significantly lower following eradication therapy. The prevalence …