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| |  Antibiotics More Cost-Effective in Treating Peptic Ulcer Disease ALBUQUERQUE, N.M., Oct. 17, 1996 -- Health care costs and the number of work days lost to illness both decrease when doctors prescribe the combination of clarithromycin and omeprazole to treat patients with "Helicobacter pylori (H. pylori)" infection-associated duodenal ulcers rather than traditional ulcer disease treatments, according to results of a study presented today at a major international medical meeting. Ulcer disease once was believed to be caused by excess stomach acid and lifestyle factors such as stress and diet; however, scientists have proven that, in fact, approximately 90 percent of ulcer disease can be associated with infection by the "H. pylori" bacterium. Traditional treatment with acid-blocking agents may control symptoms and assist in ulcer healing, but they do not treat the cause of the ulcer. As a result, ulcer recurrence has remained problematic with the older therapies. In a double-blind study led by Amnon Sonnenberg, M.D., of the Albuquerque Veterans Affairs Hospital, patients receiving clarithromycin and omeprazole experienced fewer endoscopies (an uncomfortable procedure during which the physician inserts a viewing device down a patient's throat to look for ulcers in the stomach), emergency room visits, hospitalizations, and lost work days. The clarithromycin plus omeprazole patient group experienced greater rates of "H. pylori" eradication than patients treated with either of the two older acid-blocking therapies, omeprazole or ranitidine, alone. "Within one year, utilization of health care resources was significantly reduced when "H. pylori" infection was eradicated by antibiotic therapy. This leads to economic savings for both the patient and the health care provider," said Dr. Sonnenberg. "By reducing medical care, the provider saves money. And the patients save money because they receive effective treatment for curing their ulcer disease, keeping them out of the hospital, out of the doctor's office, and on the job." Results of the multi-center study were presented at the IX International Workshop on Gastroduodenal Pathology and "Helicobacter pylori" in Copenhagen, Denmark. Dr. Sonnenberg and his research colleagues tracked the consumption of health care resources by 819 patients diagnosed with duodenal ulcer disease for one year via monthly phone interviews. During the study period, in the group of 243 patients on clarithromycin plus omeprazole, there were no ulcer-related hospital stays, compared with five in the 248-patient omeprazole-only group and six in the 236-patient ranitidine-only group, saving $130,000 when compared with the ranitidine arm of the study. The number of endoscopies endured by patients was 31 for the clarithromycin-omeprazole arm, less than half of either the 76 in the omeprazole-only arm, or 72 in the ranitidine arm of the study. Patients in the clarithromycin-omeprazole group lost a total of 104 work days to ulcer-related conditions, while patients treated with ranitidine missed 467 days, and those taking omeprazole lost 183 days. Costs for ulcer medications varied from a total of $50,512 for the clarithromycin-omeprazole patient group to $78,992 for the omeprazole-only patient group and $79,969 for the ranitidine patient group. "It is important for physicians to change their prescribing habits and recognize antibiotic treatments for ulcer disease as the most effective therapy from both a medical and economic perspective," commented Dr. Sonnenberg. "This study corroborates other studies proving clarithromycin-plus-omeprazole treatment is effective in curing ulcer disease. Ulcer treatment with antibiotic regimens targets the ulcer disease at its source and eliminates chronic medication with traditional acid-blocking ulcer therapies. This study proves that antibiotic therapy provides a higher success rate in reducing ulcer symptoms in patients while also reducing treatment costs." Previous studies have confirmed that ulcer recurrence is dramatically reduced when "H. pylori" infection is eradicated with antibiotic therapy. This is the first study proving the cost-and-outcome benefits of such eradication gathered from a clinical trial. The cost benefit proved to be relevant in the studied one-year time period, and it can be assumed to become much larger over the lifetime of an ulcer patient. Almost 18 million Americans are currently diagnosed with active ulcers. Ulcers cost the U.S. health care system more than $4.2 billion per year, and cost employers more than $1.4 billion per year in employee absences. The Department of Veterans Affairs' research program was developed as part of an affiliation of VA hospitals and medical schools to enhance patient care. The VA's research program provides improved medical care for veterans, as well as the general population. Through its unique affiliation with medical schools, the VA plays a crucial role in educating future physicians in research and clinically oriented areas. The VA continues its commitment and dedication to research and enhancing the quality of life for veterans and the surrounding community.
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