BMJ 2001;322:557 ( 3 March )

Letters

Eradicating Helicobacter pylori in non-ulcer dyspepsia may not be cost effective

The first 150 words of the full text of this article appear below.

EDITOR---Finding that patients with dyspepsia gain modest benefits from eradication of Helicobacter pylori, Moayyedi et al conclude that this intervention "may be cost effective."1 This conclusion should be taken with quite a bit of healthy scepticism. They say that one patient benefiting out of 15 treated with antibiotics may represent good value for money, depending on decision makers' willingness to pay for relief of dyspepsia. However, the risks associated with the antibiotic treatment are not taken into account in the economic model used.

The table summarises the results of two of the included trials, 2 3 showing an absolute increase in withdrawal from the trial due to adverse events. Number needed to harm values are very close to the number needed to treat found by Moayyedi et al, meaning that of each 15 patients treated one could benefit but another one could experience side effects leading to withdrawal from the trial. . . . [Full text of this article]
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Relevant Article

Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia
Paul Moayyedi, Shelly Soo, Jonathan Deeks, David Forman, James Mason, Michael Innes, and Brendan Delaney
BMJ 2000 321: 659-664. [Abstract] [Full Text] [PDF]

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