Vaccines for the 21st Century A Tool for Decisionmaking (2000) / Chapter Skim
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Appendix 7: Helicobacter pylori
Appendix 7: Helicobacter pylori
Pages 181-188
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From page 181... ...
pylori has been associated with duodenal ulcers. Chronic superficial gastritis may progress to chronic gastric atrophy with the possible risk of gastric adenocarcinoma.
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From page 182... ...
pylori infection (see Table A7-24. Some of the chronic manifestations last for decades; others manifest for much shorter periods of time.
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From page 183... ...
HUI states associated with these latent conditions range from .40 for acute complications of peptic ulcer disease to .74 for recurrences of chronic, mild peptic ulcer disease, to .82 for the average state during the year of life from diagnosis of cancers to death. COST INCURRED BY DISEASE Table A7-3 summarizes the health care costs incurred by H
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From page 184... ...
184 VACCINES FOR THE21ST CENTURY % with Cost per Care Unit Units per Case Form of Treatment GASTRITIS acute gastritis at initial 100% $10 1.0 medication a infection 80% $50 1.0 physician a 25% $100 1.0 physician b 50% $50 1.0 diagnostic a 50% $100 1.0 diagnostic b 10% $1,000 1.0 outpatient su 5% $500 2.0 surgical staff 25% $150 l.O medication c Gastritis recurrent chronic mild symptoms no 100% $10 1.0 medication a transition to PUD 2 days per month; continues for 10% $50 1.00 physician a remaining lifetime 5% $100 1.00 physician b Gastritis to PUD chronic mild symptoms until 100% $10 6.0 medication a PUD diagnosis made 2 days per month; continues for 10% $50 1.00 physician a 30 years PEPTIC ULCER DISEASE: average 30-year lag from initial infection Peptic Ulcer Disease acute PUD 100% $10 1.0 medication a 100% $50 1.0 physician a 100% $100 2.0 physician b 50% $500 1.0 diagnostic c 25% $1,000 1.0 outpatient surgery 25% $500 2.0 surgical staff 25% $500 1.0 diagnostic c 75% $150 1.0 medication c Peptic Ulcer Disease (untreated) chronic mild symptoms 100% $10 1.0 medication a 2 days per month; continues for 100% $50 1.00 physician a remaining lifetime 25% $100 1.00 physician b 50% $50 1.00 diagnostic a 50% $150 1.00 medication c Peptic Ulcer Disease ("/complications)
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From page 185... ...
It was assumed that half these patients receive a relatively expensive diagnostic procedure. It was assumed that 25% of patients receive ambulatory surgery for these symptoms, and that 75% of acute PUD patients receive expensive prescription medications.
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From page 186... ...
pylori were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population, the annualized present value of the health care costs saved would be $430 million. Using committee assumptions of less-than-ideal efficacy and utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the health care costs saved would be $67.3 million.
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From page 187... ...
A Population-Based Serologic Survey of Helicobacter pylori Infection in Children and Adolescents in the United States. The Journal of Infectious Diseases 1996; 174:1120-1123.
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