งานนำเสนอเรื่อง: "Cost-effectiveness analysis of Helicobacter pylori screening in Thailand Nisachol Cetthakrikul, Thanawat Wongphan, Jongkol Lertiendumrong, Jittinan Aukayanagul,"— ใบสำเนางานนำเสนอ:
1 Cost-effectiveness analysis of Helicobacter pylori screening in Thailand Nisachol Cetthakrikul, Thanawat Wongphan, Jongkol Lertiendumrong, Jittinan Aukayanagul,Kumaree Pachanee, Phusit Prakongsai.International Health Policy Program (IHPP), Ministry of Public Health, ThailandPresented by Nisachol Cetthakrikul8th May 2013
7 Why do we have to conduct this research? H. pylori screening methods have not been included in the UHC benefit package,In 2011, The research was submitted by researchers from health academics groups
8 ObjectivesTo explore the cost-effectiveness of five different screening methods for H. pylori infection:endoscopic gastric biopsy and rapid urease test (RUT) + Histology (If RUT is negative) ;urea breath test (UBT);serology;stool polymerase chain reaction (PCR); andtherapeutic diagnosis
10 Advantage/Disadvantage Preliminary resultsMethodsAdvantage/DisadvantageEndoscopic gastric biopsy and RUT (and histology if needed)The gold standard of H. pylori screening is recommended by the Gastroenterological Association of ThailandUBTSimple screening method, widely used in developed countries, but not in Thailand due to its high costs (2,500 Baht/case)SerologyConvenient for epidemiological investigationStool PCRComplicated sampling techniques which can be inconvenient in clinical practiceTherapeutic diagnosisBased on personal judgment of the physicians
11 Preliminary results: Parameters Prevalence of H Pylori in Thailand40.2Sensitivitysensitivity of UBT87.5sensitivity of RUT97.3sensitivity of serology88.3sensitivity of stool PCR59.1sensitivity of histology95.1Specificityspecificity of UBT90.6specificity of RUT95.0specificity of serology78.8specificity of stool PCRspecificity of histology75.1
12 QoL among different groups Preliminary results: QOL parameterQoL among different groupsQALYQoL of non-infected person0.915QoL of infected person and being eradicated0.716QoL of infected person and not being eradicated0.609ReferencesXie, F., et al., Illustrating Economic Evaluation of Diagnostic Technologies: Comparing Helicobacter pylori Screening Strategies in Prevention of Gastric Cancer in Canada. ournal of the American College of Radiology, (5).Xie, F., N. Luo, and H.-P. Lee, Cost effectiveness analysis of population-based serology screening and 13C-Urea breath test for Helicobacter pylori to prevent gastric cancer: A markov model. World Journal of Gastroenterology, (14).
13 Preliminary results: costing parameters Screening methodBaht / test*£/test**USD/test***UBTรอเก็บข้อมูล13361.3RUT95.0Serology256.312937.4Stool PCRHistology110Therapeutic diagnosis970.65( )40* โรงพยาบาลธรรมศาสตร์, โรงพยาบาลมหาราชนครราชสีมา, โรงพยาบาลศิริราช, กรมวิทยาศาสตร์การแพทย์ กระทรวงสาธารณสุข** Which test is best for Helicobacter pylori? A cost-effectiveness model using decision analysis.*** Validity and cost comparison of 14carbon urea breath test for diagnosis of H Pylori in dyspeptic patients