P255 Cost-effectiveness analysis of vonoprazan versus lansoprazole in the medical management of erosive oesophagitis
Abstract
Introduction Oesophagitis is the inflammation of the oesophageal lining following the reflux of acidic stomach contents. When this causes breaks in the oesophageal lining, it is termed erosive oesophagitis. In the UK, the management of erosive oesophagitis can be separated into two phases: healing and maintenance. For healing, a gold-standard treatment is lansoprazole, a proton-pump-inhibitor (PPI). Recent evidence attests to the superiority of vonoprazan, a potassium-competitive-acid-blocker, in the management of erosive oesophagitis. Therefore, a thorough economic assessment of vonoprazan and lansoprazole is warranted, in the context of a budget-constrained National Health Service (NHS). This cost effectiveness analysis (CEA) aims to compare vonoprazan against lansoprazole for the healing phase of erosive oesophagitis in the NHS. Methods A systematic review of the efficacy of vonoprazan versus lansoprazole was conducted. A CEA was carried out using health outcome data from a double-blind RCT conducted by Laine et al. Costs in pounds sterling were calculated in monetary units, and effectiveness was determined based on whether the oesophageal lining had healed. This enabled calculation of an incremental cost-effectiveness ratio (ICER). To contextualise this within the NHS, an ICER/QALY value was determined using QALY data from the 2008 REFLUX trial. Results As of 2022, an ICER of £1878.27 was calculated, suggesting that vonoprazan has greater efficacy than lansoprazole, but…
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