Cost Analysis in Helicobacter pylori Eradication Therapy Based on a Database of Health Insurance Claims in Japan

Figures & data

Figure 1 Selection of study population. This analysis included patients who were prescribed medication for H. pylori first-line eradication therapy from March 2015 to June 2018.

Notes: ^aP-CAB group: patients who were prescribed a P-CAB-based regimen for first-line eradication therapy. ^bPPI group: patients who were prescribed a PPI-based regimen for first-line eradication therapy.

Abbreviations: AMPC, amoxicillin; CAM, clarithromycin; EPZ, esomeprazole; ICD, International Classification of Diseases; LPZ, lansoprazole; OPZ, omeprazole; P-CAB, potassium-competitive acid blocker; PPI, proton pump inhibitor; RPZ, rabeprazole; VPZ, vonoprazan.

Table 1 Characteristics of Study Population in the P-CAB and PPI Regimens Before and After Propensity Score Matching

	Unmatched		Matched^a		Standardized Mean Difference
	P-CAB (n=50,396)	PPI (n=22,005)	P-CAB (n=22,002)	PPI (n=22,002)
Age (years), mean ± SD	50.8±10.2	51.7±10.1	51.6±10.1	51.7±10.1	−0.008
Male	29,377 (58.3)	12,624 (57.4)	12,737 (57.9)	12,622 (57.4)	0.011
High-dose CAM (800 mg/day)	14,771 (29.3)	7,794 (35.4)	7824 (35.6)	7792 (35.4)	0.003
Insurance name of disease^b
Gastritis^c	18,663 (37.0)	6,723 (30.6)	6,813 (31.0)	6,723 (30.6)	0.009
Peptic ulcer^c	12,982 (25.8)	6,639 (30.2)	6,686 (30.4)	6,638 (30.2)	0.005
Gastric cancer^d	255 (0.5)	97 (0.4)	96 (0.4)	97 (0.4)	−0.001
Idiopathic thrombocytopenic purpura^c	50 (0.1)	38 (0.2)	30 (0.1)	35 (0.2)	−0.006
Gastric MALT lymphoma^c	28 (0.1)	7 (0.03)	10 (0.05)	7 (0.03)	0.007
Gastroesophageal reflex disease	10,389 (20.6)	4,803 (21.8)	4,747 (21.6)	4,802 (21.8)
Triple-drug blister packaged products	25,463 (50.5)	16,771 (76.2)	10,897 (49.5)	16,768 (76.2)
Medical facilities with <100 beds	32,074 (63.7)	14,168 (64.8)	13,906 (63.2)	14,168 (64.8)

Notes: All data are n (%) unless otherwise noted. ^aThe propensity score matching was used to account for imbalance in the characteristics of study population (age, gender, CAM dose, insurance names of disease) between the P-CAB and PPI regimens. ^bThe insurance name of disease was compiled for 6 months before starting first-line eradication therapy, including duplicates of insurance name for a patient. ^cICD-10 codes were K29.6 for gastritis, K25/K26 for peptic ulcer, D69.3 for idiopathic thrombocytopenic purpura, and C88.4 for gastric MALT lymphoma referred to in the ICD-10 list (version 2013) at the Ministry of Health, Labour and Welfare (https://www.mhlw.go.jp/toukei/sippei/index.html). ^dCodes for medical service fees for gastric cancer were K653, K655-2, K655-4, K655-5, and K657-2 referred to by the Medical Fee Information Service (http://www.iryohoken.go.jp/shinryohoshu/).

Abbreviations: CAM, clarithromycin; ICD, International Classification of Diseases; MALT, mucosa-associated lymphoid tissue; P-CAB, potassium-competitive acid blocker; PPI, proton pump inhibitor; SD, standard deviation.

Figure 2 Total costs for Helicobacter pylori eradication therapy between the P-CAB regimen and PPI regimens. Total costs are presented as mean values per patient.

Abbreviations: JPY, Japanese yen; P-CAB, potassium-competitive acid blocker; PPI, proton pump inhibitor.

Figure 3 Total costs for Helicobacter pylori eradication therapy between the CAM 400 mg/day and CAM 800 mg/day groups in P-CAB and PPI-based regimens. Total costs are presented as mean values per patient.

Abbreviations: CAM, clarithromycin; JPY, Japanese yen; P-CAB, potassium-competitive acid blocker; PPI, proton pump inhibitor.

Figure 4 Total costs for Helicobacter pylori eradication therapy per patient between CAM 400 mg/day and CAM 800 mg/day in P-CAB treated patients with smoking habit or overweight/obese. Total costs are presented as mean values per patient.

Abbreviations: BMI, body mass index; CAM, clarithromycin; JPY, Japanese yen; P-CAB, potassium-competitive acid blocker.