CHICAGO — A community screening and treatment program for Helicobacter pylori infection significantly reduced the use of dyspepsia-related health resources, Alexander Ford, M.B., reported at the annual Digestive Disease Week.
Antimicrobial eradication therapy for H. pylori yielded a 10-year mean savings in total dyspepsia-related costs of $117 per treated individual, said Dr. Ford, of Leeds (England) General Infirmary.
The savings, mainly due to reduced prescriptions for dyspepsia, were greater than the cost of the screening, according to Dr. Ford. The reductions in total dyspepsia-related health care costs and dyspepsia-related prescribing costs were both statistically significant.
“This could be the first screening study to pay for itself,” he commented.
Study subjects were H. pylori-positive individuals who had participated in a community screening program (conducted by the Leeds HELP study group, Lancet 2000;355:1665–9) and who returned a recent dyspepsia questionnaire and consented to have their medical records examined. Of these 914 participants, 474 had originally been randomized to eradication therapy consisting of omeprazole, clarithromycin, and tinidazole for 7 days; 440 had been randomized to receive placebo.
The findings lend support to eradication therapy for H. pylori-positive individuals who have nonulcer dyspepsia, an approach for which Dr. Ford said there has been conflicting evidence.
In the United Kingdom, physicians give H. pylori eradication therapy in dyspeptic patients, he said in an interview. However, in the United States, the National Institutes of Health does not recommend eradication therapy for persons who have nonulcer dyspepsia or are asymptomatic, according to a 1994 consensus statement.
In the current study, eradication therapy was associated with a reduction in dyspepsia symptoms that was not statistically significant. Of the subjects who had dyspepsia symptoms at baseline, 59% of the treated group remained symptomatic at 10 years vs. 66% who received placebo, Dr. Ford said in an interview.
There was a possible selection bias in locating original participants of the screening program.
“We were more likely to contact people of higher socioeconomic status, and they were more likely to respond,” Dr. Ford said.