Follows, M.; Axon, A.T.R.; Chalmers, D.M.; Moayyedi, P.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA81
Academic Journal
Introduction: Over £500000/year is spent on anti-secretory therapy in the UK and until recently they were the most expensive drug class in the NHS budget. The treatment of upper gastrointestinal symptoms does not save life so we need to be sure that this money is being spent appropriately. We have previously shown that quality adjusted life years are not sufficiently sensitive to measure the value of treating dyspepsia symptoms. We have therefore assessed directly how much dyspepsia patients are willing to pay for cure of their symptoms. Methods: Unselected patients with dyspepsia attending for endoscopy were interviewed. Demographic and income data were collected and also a validated dyspepsia questionnaire was administered. Patients were asked to place a monetary value on a hypothetical drug that had a 20, 50, or 80% chance of curing their symptoms. The patient bid higher or lower from a randomly selected starting point between £5 and 50 until they were satisfied that the correct price had been reached. Results: 193 patients completed the interview (mean age = 50, range 19-76 years; 89 (46%) male). Patients were willing to pay £11.52 (95% CI = 9.60 to 13.45) for a drug with a 20% chance of curing their symptoms, £20.24 (95% CI = 18.15 to 22.34) for a 50% chance of curing their symptoms and £30.13 (95% CI = 27.88 to 32.37) for a drug with an 80% chance of curing their symptoms. These costs did not statistically significantly alter with increasing severity of dyspepsia or endoscopy diagnosis. In a multiple regression model including age, sex, income, educational status, endoscopy diagnosis, dyspepsia score, most troublesome symptom, and starting bid the only significant predictor of the amount patients were willing to pay was the starting bid (0.23; 95% CI = 0.09 to 0.37 per unit increase in starting bid). Conclusions: These data suggest lower priced drugs such as generic H[sub 2] receptor antagonists and prokinetics are value for...


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