OBJECTIVE: To compare the cost of UK licensed PPI-based triple therapies for the eradication of H. pylori from the perspective of the National Health Service. METHODS: A recent meta-analysis of trials comparing all UK licensed PPI-based triple therapies using amoxicillin and clarithromycin over a 7-day period found no significant difference in the rate of H. pylori eradication. Mean per patient costs were calculated by multiplying the resource utilisation incurred by their respective national published unit costs at year 2003 prices. To estimate the impact of using the least expensive triple therapy on a typical Primary Care Organisation (PCO), differences in mean per patient cost were multiplied by the annual incidence of H. pylori compared to current expenditure. Current expenditure was based on national usage pattern of the available treatment options. Sensitivity analysis was conducted to assess the impact of administering omeprazole 40mg once daily vs omeprazole 20mg twice daily and the availability of generic omeprazole. RESULTS: Mean per patient cost for a 7-day esomeprazole-based treatment regimen was £34.24, £5.03 lower than omeprazole-, £2.58 less than lansoprazole- and pantoprazole-, and £2.13 lower than rabeprazole-based triple therapies. The budget impact analysis suggests that a typical PCO could save up to £4386 per annum if only esomeprazole-based triple therapy were used for H. pylori eradication. Sensitivity analyses found the results were robust to changes in key model parameters. CONCLUSIONS: Esomeprazole-based triple therapy is the least expensive treatment option for the eradication of H. pylori licensed for use in the UK.