OBJECTIVES:

The high prevalence of Helicobacter pylori (H. pylori) infection in China results in a substantial public health burden. Proton-pump inhibitor (PPI)-bismuth-containing quadruple therapy (BQT) is the most common treatment option for eradication of Helicobacter pylori in China. The advent of vonoprazan has brought a new treatment option. The aim of this study was to determine the health economic impact of vonoprazan-bismuth containing quadruple therapy (VBQT) compared with BQT in asymptomatic, infected populations.

METHODS:

A Markov model was applied to evaluate the cost-effectiveness of H. pylori eradication strategies. The long-term costs of H. pylori eradication therapy were calculated from the perspective of healthcare system in China. The main outcomes included gastric cancer incidence reduction, number of cause-specific deaths, costs, quality-adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER). Epidemiological parameters and health utilities used in the model were collected from published literatures or statistical bureaus. A sensitivity analysis was conducted to explore the influence of parameters on the uncertainty of the model.

RESULTS:

Compared with the BQT group, VBQT therapy brought an average of 0.051 incremental QALYs (17.74 QALYs vs 17.69 QALYs) and saved ￥7.36 (￥2150.61 vs ￥2157.97). VBQT group prevented 253 cases of early gastric cancer and 1011 cases of advanced gastric cancer. The cost-effectiveness analysis demonstrated that BQT group cost more and produced less QALYs. It was dominated by VBQT therapy. Results were robust in one-way and probabilistic sensitivity analyses. The probability of the VBQT therapy being cost-effective was over 95% at the threshold of one time the gross domestic product per capita of China.

CONCLUSIONS:

VBQT is effective and cost-effective compared with BQT for the eradication of H. pylori among patients with asymptomatic infection in China.