Korean J Med.  2002 May;62(5):504-512.

Cost-effectiveness analysis of proton pump inhibitors and ranitidine in the treatment of gastroesophageal reflux disease

• Yun HR
• Jung HY
• Park HJ
• Bae SC

Abstract

BACKGROUND: The aim of this study was to compare the cost-effectiveness of proton pump inhibitors (PPI) and ranitidine in gastroesophageal reflux disease (GERD) in Korea.
METHODS
We assessed the cost-effectiveness two ways. First, mean costs for the complete healing of one patient with GERD within one year were calculated. Second, Markov (state-transition) models were used to simulate a cohort of patients with GERD, taking one of following strategies for 5 years : 1) PPI (rabeprazole 10 mg, omeprazole 20 mg, or lansoprazole 30 mg), 2) ranitidine 300 mg per day. Data on healing rate, relapse rate, surgical complication rate, success rate of surgery were taken from the literature. Direct medical costs of each strategy and surgical complications were calculated. Health effects were expressed as quality-adjusted life years (QALYs). Sensitivity analyses using various ranges of probability of healing rates and costs were performed. Costs and health outcomes were discounted at a rate of 3 % per year.
RESULTS
The mean costs for complete healing of one case within one year was 475,836 in PPI and 1,064,704 in ranitidine, respectively. In the base case analysis using Markov model, the treatment costs of PPI were 155,238 and 214,781 in ranitidine and the effects were 4.81 QALYs and 4.26 QALYs, respectively; PPI strategy was more effective and less costly than ranitidine strategy. The sensitivity analyses using varying ranges of probability, cost, discount rate and utility were robust.
CONCLUSION
PPI was superior to ranitidine in terms of cost-effectiveness in the treatment of GERD.

Keyword

Cost Effectiveness; Esophagitis; Peptic; Inhibitors; Proton pump; Ranitidine

MeSH Terms

Cohort Studies
Cost-Benefit Analysis
Esophagitis
Gastroesophageal Reflux*
Health Care Costs
Humans
Korea
Lansoprazole
Omeprazole
Proton Pump Inhibitors*
Proton Pumps*
Protons*
Quality-Adjusted Life Years
Ranitidine*
Recurrence
Omeprazole
Proton Pump Inhibitors
Proton Pumps
Protons
Ranitidine