Evidence map›Paper›PMID 31396703›Full record

ArticleJournal of gastroenterology2019

Cost-utility analysis of a 'vonoprazan-first' strategy versus 'esomeprazole- or rabeprazole-first' strategy in GERD.

Yuta Yokoya, Ataru Igarashi, Akihito Uda, Hisato Deguchi, Toshihisa Takeuchi, Kazuhide Higuchi

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Journal of gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
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  4. Pooled it
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  9. Observational
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  13. Review
  14. The role of vonoprazan in patients with erosive esophagitis.Therapeutic advances in gastroenterology · 2022
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yuta YokoyaSecond Department of Internal Medicine, Osaka Medical College, 2-7 Digaku-cho, Takatsuki, Japan.
Ataru IgarashiUnit of Public Health and Preventive Medicine, School of Medicine, Yokohama City University, Yokohama, Japan.
Akihito UdaJapan Medical Affairs, Takeda Pharmaceutical Company Limited, Tokyo, Japan.
Hisato DeguchiJapan Medical Affairs, Takeda Pharmaceutical Company Limited, Tokyo, Japan.
Toshihisa TakeuchiSecond Department of Internal Medicine, Osaka Medical College, 2-7 Digaku-cho, Takatsuki, Japan. in2097@osaka-med.ac.jp.ORCID http://orcid.org/0000-0002-1233-0977
Kazuhide HiguchiSecond Department of Internal Medicine, Osaka Medical College, 2-7 Digaku-cho, Takatsuki, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGastroesophageal reflux disease (GERD) can be treated using a vonoprazan-first strategy (first-line treatment with vonoprazan), or esomeprazole-first/rabeprazole-first strategies (first-line treatment with proton-pump inhibitors [PPIs], esomeprazole/rabeprazole, followed by a switch to vonoprazan). This cost-utility analysis used long-term simulation modeling to evaluate the cost-effectiveness of a vonoprazan-first strategy compared with the esomeprazole-first and rabeprazole-first strategies.

methodsA Markov simulation model was developed to evaluate the cost-effectiveness of vonoprazan-first, esomeprazole-first, and rabeprazole-first strategies, comprising healing and maintenance therapies, over 5 years (4-week cycles). Healing therapy began with the administration of a normal dose of drug per real-world practice. If patients were not healed endoscopically, either a longer duration of healing therapy was provided (vonoprazan), the dose was increased (rabeprazole), or patients were switched to vonoprazan (immediately for esomeprazole, and after dose-escalation for rabeprazole, respectively). Healed patients received maintenance (lower/same dose as healing therapy). Recurrence resulted in re-challenge with healing therapy. Transition probabilities were derived from the results of indirect comparisons (network meta-analysis) and costs calculated from the Japanese payer perspective. Outcomes were defined as quality-adjusted life years (QALYs), with utilities based on published values.

resultsExpected costs of the vonoprazan-, esomeprazole-, and rabeprazole-first strategies were ¥36,194, ¥76,719, and ¥41,105, respectively, over 5 years. QALY gains for vonoprazan-first strategy versus the esomeprazole- and rabeprazole-first strategies were 0.014 and 0.003, respectively. Both estimated incremental cost-effectiveness ratios were dominant and robust to two sensitivity analyses.

conclusionsVonoprazan-first strategy increased QALYs and appeared to be cost-effective for GERD patients compared with the esomeprazole- or rabeprazole-first strategies.

Indexed as

Computer SimulationCost-Benefit AnalysisEsomeprazoleGastroesophageal RefluxHumansJapanMarkov ChainsProton Pump InhibitorsPyrrolesQuality-Adjusted Life YearsRabeprazoleRecurrenceSulfonamidesTime FactorsTreatment Outcome1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamineEsomeprazoleProton Pump InhibitorsPyrrolesRabeprazoleSulfonamidesCost-utility analysisGastroesophageal reflux diseaseProton-pump inhibitorVonoprazan

Identifiers

PMID31396703

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.