Non-variceal upper gastrointestinal bleeding (NVUGIB) is a common cause of hospitalization all over the world including in Taiwan. Patients with NVUGIB in general practice are often treated empirically with a standard dose of IV proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs). Despite clinical evidence in favour of IV PPIs, FDA has not yet been proved PPIs in this indication. OBJECTIVE: To compare the cost effectiveness of IV PPIs and H2RAs in the treatment of NVUGIB, we assessed the rebleeding rate of initial medication choice (IV PPIs or H2RAs) and direct medical cost using healthcare claims data in Taiwan . METHODS: We designed a two-year retrospective longitudinal analysis between January 1, 2002, and January 31, 2004 to compare the 60-days rebleeding rate from the healthcare claims in southern Taiwan, with about three million members. We constructed a decision tree model comparing two strategies: IV PPIs and IV H2RAs started in the NVUGIB patients following endoscopic therapy. The model was evaluated the rebleeding to initial therapy and the rebleeding prevented by competing different strategies. Sensitivity analysis was used in the decision to evaluate the strategies. Charlson comorbidity score was used to adjust for severity. RESULTS: After endoscopic therapy, severely rebleeding is still common in Taiwan need for further endoscopic haemostasis or surgery. Analysis showed that the cost-effectiveness ratios for IV PPIs and H2RAs groups were NT46761.18 and NT45107.88, respectively, in averting one episode of recurrent bleeding in one patient after initial hemostasis was achieved. CONCLUSIONS: It is common in Taiwan to administer IV H2RAs to patients with UGIB. The analysis suggest that the use of IV PPIs in conjunction with endoscopy haemostasis in a standard dose was not superior effectiveness based on the probability determination used in the sensitivity analysis.