What are the treatment goals for Helicobacter pylori infection?

Abstract

The goals of therapy of Helicobacter pylori are commonly viewed as either clinical (e.g., avoid further morbidity, mortality, or prevent disease from occurring) or economic (e.g., save healthcare dollars by avoiding further expenditure of resources). However, when viewed globally, these goals are not incongruent but are inexorably linked. Prevention of disease or avoidance of further morbidity and mortality by curing H. pylori infection is obviously an improved clinical outcome, but it also concurrently avoids further utilization of healthcare resources and is "cost-effective," resulting in improved economic outcome as well. The more clinically effective an H. pylori treatment is, the more economically effective it is as well. When comparing regimens, the cost-effectiveness is determined by efficacy of the regimen, not its cost. Put more simply, "The most expensive therapy is the one that doesn't work!" Therefore, the goals of the therapy are simple: avoid further morbidity, mortality, and prevent disease while minimizing further utilization of healthcare resources, thus saving money. The most clinically effective therapy is also the most cost-effective therapy. Regimens used should have demonstrated greater than 90% efficacy or effectiveness in the population being treated for H. pylori infection. The regimens should be simple and well tolerated. It is clinically and economically inappropriate to use a regimen not meeting these criteria.