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Treatment strategies for reflux esophagitis including a potassium‐competitive acid blocker: A cost‐effectiveness analysis in Japan

INTRODUCTION: Gastroesophageal reflux disease is a common condition, and proton pump inhibitors (PPIs) are the mainstays of treatment. However, concerns have been raised about the safety of PPIs. A potassium‐competitive acid blocker (P‐CAB), vonoprazan (VPZ), was recently introduced, which may provi...

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Autores principales: Habu, Yasuki, Hamasaki, Ryuhei, Maruo, Motonobu, Nakagawa, Tatsuya, Aono, Yuki, Hachimine, Daisaku
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411401/
https://www.ncbi.nlm.nih.gov/pubmed/34484992
http://dx.doi.org/10.1002/jgf2.429
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author Habu, Yasuki
Hamasaki, Ryuhei
Maruo, Motonobu
Nakagawa, Tatsuya
Aono, Yuki
Hachimine, Daisaku
author_facet Habu, Yasuki
Hamasaki, Ryuhei
Maruo, Motonobu
Nakagawa, Tatsuya
Aono, Yuki
Hachimine, Daisaku
author_sort Habu, Yasuki
collection PubMed
description INTRODUCTION: Gastroesophageal reflux disease is a common condition, and proton pump inhibitors (PPIs) are the mainstays of treatment. However, concerns have been raised about the safety of PPIs. A potassium‐competitive acid blocker (P‐CAB), vonoprazan (VPZ), was recently introduced, which may provide clinical benefits. This study was performed to investigate the cost‐effectiveness of alternative long‐term strategies including continuous and discontinuous treatment with VPZ for the management of reflux esophagitis in Japan. METHODS: A health state transition model was developed to capture the long‐term management of reflux esophagitis. Four different strategies were compared: (a) intermittent PPI using lansoprazole (LPZ); (b) intermittent P‐CAB; (c) maintenance PPI using LPZ; and (d) maintenance P‐CAB. RESULTS: Intermittent P‐CAB was the most cost‐effective, and the number of days for which medication was required with this strategy was fewest. Maintenance PPI was more efficacious, but more costly than intermittent P‐CAB. Maintenance P‐CAB was more efficacious, but more costly than maintenance PPI. Co‐payments were higher for maintenance PPI than for intermittent P‐CAB, and for maintenance P‐CAB than for maintenance PPI, which were considered reasonable for the majority of patients to improve symptoms. CONCLUSIONS: Intermittent P‐CAB appears to be the strategy of choice for the majority of reflux esophagitis patients in clinical practice. If a patient is not satisfied with the symptom control of the current strategy, switching to a more effective strategy appears to be a reasonable option for the majority of patients.
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spelling pubmed-84114012021-09-03 Treatment strategies for reflux esophagitis including a potassium‐competitive acid blocker: A cost‐effectiveness analysis in Japan Habu, Yasuki Hamasaki, Ryuhei Maruo, Motonobu Nakagawa, Tatsuya Aono, Yuki Hachimine, Daisaku J Gen Fam Med Original Articles INTRODUCTION: Gastroesophageal reflux disease is a common condition, and proton pump inhibitors (PPIs) are the mainstays of treatment. However, concerns have been raised about the safety of PPIs. A potassium‐competitive acid blocker (P‐CAB), vonoprazan (VPZ), was recently introduced, which may provide clinical benefits. This study was performed to investigate the cost‐effectiveness of alternative long‐term strategies including continuous and discontinuous treatment with VPZ for the management of reflux esophagitis in Japan. METHODS: A health state transition model was developed to capture the long‐term management of reflux esophagitis. Four different strategies were compared: (a) intermittent PPI using lansoprazole (LPZ); (b) intermittent P‐CAB; (c) maintenance PPI using LPZ; and (d) maintenance P‐CAB. RESULTS: Intermittent P‐CAB was the most cost‐effective, and the number of days for which medication was required with this strategy was fewest. Maintenance PPI was more efficacious, but more costly than intermittent P‐CAB. Maintenance P‐CAB was more efficacious, but more costly than maintenance PPI. Co‐payments were higher for maintenance PPI than for intermittent P‐CAB, and for maintenance P‐CAB than for maintenance PPI, which were considered reasonable for the majority of patients to improve symptoms. CONCLUSIONS: Intermittent P‐CAB appears to be the strategy of choice for the majority of reflux esophagitis patients in clinical practice. If a patient is not satisfied with the symptom control of the current strategy, switching to a more effective strategy appears to be a reasonable option for the majority of patients. John Wiley and Sons Inc. 2021-02-21 /pmc/articles/PMC8411401/ /pubmed/34484992 http://dx.doi.org/10.1002/jgf2.429 Text en © 2021 The Authors. Journal of General and Family Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Primary Care Association. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Habu, Yasuki
Hamasaki, Ryuhei
Maruo, Motonobu
Nakagawa, Tatsuya
Aono, Yuki
Hachimine, Daisaku
Treatment strategies for reflux esophagitis including a potassium‐competitive acid blocker: A cost‐effectiveness analysis in Japan
title Treatment strategies for reflux esophagitis including a potassium‐competitive acid blocker: A cost‐effectiveness analysis in Japan
title_full Treatment strategies for reflux esophagitis including a potassium‐competitive acid blocker: A cost‐effectiveness analysis in Japan
title_fullStr Treatment strategies for reflux esophagitis including a potassium‐competitive acid blocker: A cost‐effectiveness analysis in Japan
title_full_unstemmed Treatment strategies for reflux esophagitis including a potassium‐competitive acid blocker: A cost‐effectiveness analysis in Japan
title_short Treatment strategies for reflux esophagitis including a potassium‐competitive acid blocker: A cost‐effectiveness analysis in Japan
title_sort treatment strategies for reflux esophagitis including a potassium‐competitive acid blocker: a cost‐effectiveness analysis in japan
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411401/
https://www.ncbi.nlm.nih.gov/pubmed/34484992
http://dx.doi.org/10.1002/jgf2.429
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