Registry analysis reveals bismuth quadruple therapy is the most cost-effective first-line Helicobacter pylori eradication strategy, indicating optimal empirical treatment options.
Background/Aims: Current Korean guidelines recommend five different strategies for first-line eradication. No study has compared the cost-effectiveness of these five strategies in Korea. Methods: registry. Results: Among the empirical regimens, 14-day CTT showed the lowest eradication rate and highest cost. In contrast, ST, CT, and BQT demonstrated lower costs and higher eradication rates than 14-day CTT. TT achieved an overall eradication rate of 88.9% at a total cost of USD 221.91, which was higher than that of any empirical regimen. Compared with BQT, TT was associated with higher costs and lower eradication rates. Compared with ST, CT, and CTT, TT incurred higher costs but achieved higher eradication rates, with incremental cost-effectiveness ratios ranging from USD 3.82 to USD 21.34 per 1% increase in eradication rate. Conclusions: BQT demonstrated the most favorable cost-effectiveness among the first-line regimens recommended by the Korean guidelines. Although TT proved to be more cost-effective than CTT, it did not demonstrate superior cost-effectiveness compared with BQT.
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Kim et al. (2026) studied this question.
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