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Helicobacter pylori and Peptic Ulcer Disease
Economics of peptic ulcer disease and H. pylori infection
Peptic ulcer disease has a large impact on the U.S. health care system.
One out of ten Americans suffers from peptic ulcer disease during their lifetime. Ulcers cause an estimated 1 million hospitalizations and 6500 deaths per year. In the United States, annual health care costs of peptic ulcer disease have been estimated at nearly $6 billion: $3 billion in hospitalization costs, $2 billion in physician office visits, and $1 billion in decreased productivity and days lost from work.
Curing an ulcer with antibiotic therapy is cost-effective.
We now know that nine out of ten peptic ulcers are caused by an infection with the bacterium, Helicobacter pylori and not by stress or spicy foods as previously thought. Curing the infection with antibiotics shortens ulcer healing time and significantly reduces the ulcer recurrence rate compared with traditional ulcer therapies such as acid-reducing medications. H. pylori infection can usually be cured with a two-week regimen of antibiotics. In more than 80 percent of patients, the ulcer is cured and does not recur.
Antibiotic therapy has a much greater effect on lowering the overall cost of peptic ulcer disease.
Studies indicate that curing an ulcer with antibiotics takes less time and costs less than one-tenth the amount of treating ulcer symptoms over a lifetime. Maintenance therapy with acid- reducing medications costs approximately $11,000 and requires 187 days of treatment over 15 years. Vagotomy, a more extreme treatment, is also quite costly at $17,000 and requires 307 days of treatment over a 15- year period. Conversely, antibiotic therapy takes 17 days and costs less than $1,000 over the same period of time.
Antibiotic therapy is cost effective in a managed care setting.
Recent cost analyses, economic decision models and a randomized controlled trial have all shown that eradicating H. pylori from patients with peptic ulcer disease results in decreased health care costs. In a study at a large health maintenance organization, H. pylori eradication in peptic ulcer disease patients resulted in a decreased use of outpatient services and, thus, a decreased cost of follow-up care.
The Centers for Disease Control and Prevention (CDC) is working to reduce the economic burden of peptic ulcer disease.
CDC, in partnership with other government agencies, academic institutions, and industry, is conducting a national education campaign to inform health care providers and consumers of the association between H. pylori and peptic ulcer disease. Awareness of this association will result in improved diagnosis and treatment of persons with peptic ulcer disease, which will ultimately result in decreased health care use and cost.
Sonnenberg A, Everhart JE. Health impact of peptic ulcer in the United States. Am J Gastroenterol 1997;92:614-620.
Graham DY, Lew GM, Klein PD, et al. Effect of treatment of Helicobacter pylori infection on the long term recurrence of gastric or duodenal ulcer: a randomized controlled study. Ann Intern Med 1992;116:705-8.
Sonnenberg A, Townsend WF. Costs of duodenal ulcer therapy with antibiotics. Arch Intern Med 1995;155:922-928.
Levin TR, Schmittdiel JA, Henning JM, et al. A cost analysis of a Helicobacter pylori eradication strategy in a large health maintenance organization. Am J Gastroenterol 1998; 93:743-747.
For further information, contact:
Health Communications Activity
Division of Bacterial and Mycotic Diseases
Coordinating Center for Infectious Diseases
Centers for Disease Control and Prevention
1600 Clifton Road, MS C09
Atlanta, GA 30333
For more information about H. pylori infection and ulcers,
see your health care provider or call toll-free: 1-888-MY-ULCER.