Document Detail

Ranitidine: a pharmacoeconomic evaluation of its use in acid-related disorders.
MedLine Citation:
PMID:  10147354     Owner:  NLM     Status:  MEDLINE    
Ranitidine is a histamine H 2-receptor antagonist which, on the basis of its well established tolerability and efficacy profile, has been widely prescribed for the treatment of ulcer disease and mild to moderate reflux oesophagitis. However, the advent of more powerful gastric acid inhibitors (e.g. acid pump inhibitors) and the realisation of the role of Helicobactor pylori infection in duodenal ulcer disease could have considerable clinical and economic implications for the use of ranitidine (and other H 2-receptor antagonists). Simulation modelling studies based on current pricing policies in Europe predict that ranitidine-based treatment will be less cost effective than omeprazole in the short term healing of duodenal ulcer and reflux oesophagitis disease. During longer term treatment, omeprazole is expected to be the dominating strategy over ranitidine-based therapy in Europe and the US. However, the inherent limitations of modelling studies reinforce the need for randomised prospective trials, preferably conducted in a general practice setting and including a quality-of-life analysis. Of the currently accepted approaches for the long term management of recurrent duodenal ulcer disease, daily maintenance therapy with ranitidine has been shown to be more cost effective than intermittent treatment for up to 2 years in the US. The annual cost of providing continuous maintenance therapy with ranitidine 150 mg/day is higher than with cimetidine 400 mg/day, although the extra benefits include a reduced risk of pain and discomfort from an expected lower rate of ulcer recurrence with ranitidine. Simultaneous ulcer healing and eradication of H. pylori markedly reduces relapse rates and is likely to become the management strategy of choice in H. pylori-positive patients, particularly with the advent of more convenient, well tolerated and effective regimens. Moreover, widespread clinical acceptance of H. pylori eradication may yield substantial cost savings to society by reducing the overall need for long term antisecretory therapy. Nonetheless, maintenance therapy with histamine H 2-receptor antagonists remains indicated for patients at high risk of ulcer recurrence who are poorly responsive to or cannot tolerate H. pylori eradication regimens. In summary, the proven efficacy and tolerability of ranitidine will ensure its continued use in the treatment of many patients with duodenal ulcer and mild to moderate reflux oesophagitis. However, there is increasing clinical and economic data favouring the selection of omeprazole in patients with more severe symptoms of these diseases.(ABSTRACT TRUNCATED AT 400 WORDS)
J E Frampton; D McTavish
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  PharmacoEconomics     Volume:  6     ISSN:  1170-7690     ISO Abbreviation:  Pharmacoeconomics     Publication Date:  1994 Jul 
Date Detail:
Created Date:  1994-11-23     Completed Date:  1994-11-23     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9212404     Medline TA:  Pharmacoeconomics     Country:  NEW ZEALAND    
Other Details:
Languages:  eng     Pagination:  57-89     Citation Subset:  T    
Adis International Limited, Auckland, New Zealand.
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MeSH Terms
Administration, Oral
Cost-Benefit Analysis
Drug Interactions
Duodenal Ulcer / drug therapy*,  etiology
Economics, Pharmaceutical / statistics & numerical data,  trends
Esophagitis, Peptic / drug therapy*,  etiology
Formularies as Topic
Helicobacter pylori / drug effects
Infusions, Intravenous / economics
Models, Econometric
Ranitidine / economics*,  therapeutic use
Treatment Outcome
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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