Economic and Antibiotic Benefits of Vonoprazan-Based Regimens for First-Line Helicobacter Pylori Eradication in China
Author(s)
Bingyun Lu, MD1, Ye Chen, MD1, Yingjie Cui, MD2, Yanan Sheng, MSc3, Li Xie, MSc3, Chengwu Shen, MD2.
1Integrative Microecology Clinical Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China, 2Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China, 3Medical Affairs, Takeda (China) International Trading Company, Beijing, China.
1Integrative Microecology Clinical Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China, 2Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China, 3Medical Affairs, Takeda (China) International Trading Company, Beijing, China.
OBJECTIVES: To evaluate the economic and antibiotic stewardship impact of vonoprazan-based regimens (bismuth quadruple [VPZ-BQT] and dual therapy [vonoprazan with high-dose amoxicillin, VPZ-HDT]) versus proton pump inhibitor-bismuth quadruple (PPI-BQT) for first-line H. pylori eradication in China, given rising antibiotic resistance and suboptimal PPI therapies.
METHODS: An epidemiological estimation of the Chinese H. pylori-infected patient population, coupled with a decision-tree model, was conducted to compare the antibiotic utilization of VPZ-BQT and VPZ-HDT versus PPI-BQT across two 14-day treatment courses. Key inputs included eradication rates, real-world antibiotic regimen distribution, and 2024 drug and healthcare costs (in Chinese yuan [¥]). Outcomes were direct medical costs (DMC), antibiotic costs (AC), antibiotic consumption (Defined Daily Doses [DDDs]), and antibiotic exposure days over a 3-year period (2025-2027). Scenario analyses explored varying VPZ-HDT utilization.
RESULTS: Compared to PPI-BQT, VPZ-BQT reduced AC by ¥17.3 per patient and national antibiotic consumption by over 0.2 billion DDDs over three years (corresponding to ¥0.8 billion AC savings), though DMC increased by ¥139.0 per patient. Scenario analysis showed increasing first-line VPZ-HDT utilization (replacing VPZ-BQT) progressively boosted AC savings and achieved net DMC savings when VPZ-HDT utilization exceeded 49.4%. Full first-line VPZ-HDT adoption saved ¥119.1 AC and ¥142.9 DMC per patient. Nationally, this projected to ¥5.8 billion AC savings and ¥7.0 billion DMC savings over three years, with over 0.9 billion fewer DDDs. Notably, VPZ-based regimens also decreased average total antibiotic exposure days compared to PPI-BQT by minimizing second-line therapy needs. While VPZ-HDT increased amoxicillin use, it facilitated a strategic shift away from clarithromycin and other antibiotics of high resistance concern.
CONCLUSIONS: VPZ-based regimens, particularly VPZ-HDT, offer notable antibiotic stewardship and economic advantages for H. pylori eradication in China, with VPZ's superior efficacy driving these positive outcomes. Strategic adoption of effective VPZ-based therapies may optimize antibiotic stewardship and support national resistance control efforts.
METHODS: An epidemiological estimation of the Chinese H. pylori-infected patient population, coupled with a decision-tree model, was conducted to compare the antibiotic utilization of VPZ-BQT and VPZ-HDT versus PPI-BQT across two 14-day treatment courses. Key inputs included eradication rates, real-world antibiotic regimen distribution, and 2024 drug and healthcare costs (in Chinese yuan [¥]). Outcomes were direct medical costs (DMC), antibiotic costs (AC), antibiotic consumption (Defined Daily Doses [DDDs]), and antibiotic exposure days over a 3-year period (2025-2027). Scenario analyses explored varying VPZ-HDT utilization.
RESULTS: Compared to PPI-BQT, VPZ-BQT reduced AC by ¥17.3 per patient and national antibiotic consumption by over 0.2 billion DDDs over three years (corresponding to ¥0.8 billion AC savings), though DMC increased by ¥139.0 per patient. Scenario analysis showed increasing first-line VPZ-HDT utilization (replacing VPZ-BQT) progressively boosted AC savings and achieved net DMC savings when VPZ-HDT utilization exceeded 49.4%. Full first-line VPZ-HDT adoption saved ¥119.1 AC and ¥142.9 DMC per patient. Nationally, this projected to ¥5.8 billion AC savings and ¥7.0 billion DMC savings over three years, with over 0.9 billion fewer DDDs. Notably, VPZ-based regimens also decreased average total antibiotic exposure days compared to PPI-BQT by minimizing second-line therapy needs. While VPZ-HDT increased amoxicillin use, it facilitated a strategic shift away from clarithromycin and other antibiotics of high resistance concern.
CONCLUSIONS: VPZ-based regimens, particularly VPZ-HDT, offer notable antibiotic stewardship and economic advantages for H. pylori eradication in China, with VPZ's superior efficacy driving these positive outcomes. Strategic adoption of effective VPZ-based therapies may optimize antibiotic stewardship and support national resistance control efforts.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE349
Topic
Economic Evaluation, Epidemiology & Public Health, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Gastrointestinal Disorders, Generics, Infectious Disease (non-vaccine)