Cost–effectiveness of high-dose intravenous esomeprazole in patients with peptic ulcer bleeding in the USA and Europe

Abstract

Evaluation of: Barkun AN, Adam V, Sung JJ et al. Cost effectiveness of high-dose intravenous esomeprazole for peptic ulcer bleeding. Pharmacoeconomics 28(3), 217–230 (2010).

Peptic ulcer bleeding (PUB) is life-threatening and associated with high healthcare costs. Clinical outcomes in PUB depend largely on the risk of rebleeding. Recent data indicate that intravenous proton pump inhibitors (PPIs) reduce rebleeds, the need for surgery and repeat endoscopic treatment. From a policy perspective, it is important to assess the cost–effectiveness of this treatment. Accordingly, a decision-tree model published by Barkun et al. evaluated the costs and benefits of high-dose intravenous esomeprazole in preventing rebleeds in patients with PUB based on data from a multinational, randomized clinical trial comparing this therapeutic approach to intravenous placebo. The results indicate that esomeprazole is cost effective in the USA and Sweden, and cost saving in Spain. These findings agree with most other analyses of intravenous PPIs used in PUB patients at high risk for bleeds. The therapeutic approach provides increased benefits to patients at a relatively small additional cost.

Keywords::

• cost–effectiveness
• endoscopy
• esomeprazole
• peptic ulcer hemorrhage
• proton pump inhibitors

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.