ArticleThe Korean journal of helicobacter and upper gastrointestinal research2026
Economic Evaluation of Empirical and Tailored Helicobacter pylori Eradication Strategies Including Second-Line Therapy.
Article in The Korean journal of helicobacter and upper gastrointestinal research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To our knowledge, no study has evaluated the cost-effectiveness of tailored therapy guided by genotypic resistance compared with empirical clarithromycin-based triple therapy, including second-line therapies. Methods: A decision tree model was developed to compare empirical and tailored treatment strategies. Cost-minimization and cost-effectiveness analyses were conducted. The incremental cost-effectiveness ratio (ICER) was calculated to compare the two strategies, including second-line therapy. Results: The empirical therapy incurred a lower cost per patient (USD 211.49) than the tailored therapy (USD 269.88). The overall eradication rates were nearly identical (97.98% vs. 98.05%), yielding an ICER of USD 859.00 per 1% gain in eradication. Empirical therapy consistently resulted in lower total costs for all treatment durations. In the 7-day regimen, empirical therapy (USD 201.52; 97.64% eradication) versus tailored therapy (USD 253.62; 98.12%) produced an ICER of USD 108.54 per 1%, in favor of the empirical approach. In the 14‑day regimen, tailored therapy was more expensive (USD 282.74 vs. USD 221.46) and slightly less effective (97.97%, 98.34%). Overall, empirical therapy is a cost-effective strategy in most cases. Conclusions: This study demonstrates that tailored therapy guided by genotypic resistance is no more cost-effective than empirical therapy when second-line therapy is included. Future studies are warranted to identify strategies to improve the cost-effectiveness of tailored therapies in clinical practice.
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