StudyMethodsOutcomesComparisonsResults
Stalhammar, 1993
Sweden
Markov
Deterministic
1 year
Discount NA
Societal costs (SEK 1991)
Healthy days
Erosive oesophagitisI1:I2:
I1:Intermittent: Omeprazole 20mg on relapseCost84688925
I2:Maintenance: Omeprazole 20mg from startEffect290353ICER: SEK16/health day
Both groups could step up to 40mg
Harris et al, 1997
USA
Markov
Deterministic
1 year
Discount NA
Direct costs (US$ 1995)
Recurrence
Erosive oesophagitisI1:I2:
I1:Maintenance dose PPICost12901157
I2:Maintenance 2X dose H2RAEffect0.1510.549ICER: $335/recurrence
I3:Maintenance with healing dose PPIHigh dose H2RA dominated.
Gerson et al, 2000
USA
Expected utility
Deterministic
1 year, but model extrapolates to lifetime costs and QALYs assuming steady state reached.
Discount: Not clear
Direct costs (US$)
QALYs
I1:antacidsI1:I2:I3:I4:I5:I6:
I2:Maintenance H2RACost ($)043299652784691376412616741112
I3:Step up H2RA – PPIEffect (QALYs)23.6624.4224.37242424.65
I4:Step down PPI –H2RAICER: $20934/QALY
I5:PPI on demandPPI on demand over antacids. All other comparisons dominated.
I6:Maintenance PPI
Ofman et al, 2002
USA
Expected utility
Deterministic
1 year.
Discount: NA
Direct costs (1997 US$)
% symptom free
I1:Step up [antacids, H2RA, PPI, investigate]I1:I2:
I2:Step down [PPI trial, H2RA, antacids]Cost$1045$1172
Effect50%75%ICER $510 in favour of step down
Briggs et al, 2002
Canadian
Expected Utility with Monte Carlo Simulation
Stochastic
1 year
Costs (2000 CAN$)I1:Intermittent Healing dose PPISee charts
I2:Continouous healing PPI
I3:Maintenance H2RA
I4:Prokinetic
I5:Step down PPI- H2RA
I6:Step down PPI- Maintenance PPI

From: Appendix 8, Economic analyses addressing management of gastro-oesophageal reflux disease (GORD)

Cover of Dyspepsia
Dyspepsia: Managing Dyspepsia in Adults in Primary Care.
NICE Clinical Guidelines, No. 17.
North of England Dyspepsia Guideline Development Group (UK).
Newcastle upon Tyne (UK): University of Newcastle upon Tyne; 2004 Aug 1.
Crown Copyright © 2004.

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