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Health Economics and Management

Cost-minimization analysis in treatment of gastroesophageal reflux disease with proton pump inhibitors

Stefka Valcheva-Kuzmanova, Ovanezyan Zhirayr


Gastroesophageal reflux disease (GERD) is a common disorder. The most effective treatment for GERD is a proton pump inhibitor (PPI). The aim of this study was to find out the available on the Bulgarian pharmaceutical market PPI and to conduct a cost-minimization analysis for the treatment of reflux esophagitis with PPI. The results showed that in Bulgaria the PPI were presented by 53 pharmaceutical products with international nonproprietary names (INN) omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole. In the cost-minimization analysis, only those drugs and dosage forms were chosen for which therapeutic equivalence had been proven in clinical trials. Drugs with INN omeprazole 20 mg daily, lansoprazole 30 mg daily, pantoprazole 40 mg daily and esomeprazole 20 mg daily a for 8-week treatment had a comparable efficacy of 85%, 86%, 89% and 87%, respectively. The cost of treatment varied to a high extent: from 7,17 BGN to 40,48 BGN. The most cost-saving treatment of GERD in our country can be achieved by drug products of pantoprazole. In conclusion, a cost-saving therapy of esophagitis in GERD might be conducted by a proper choice of the drug.


cost-minimization analysis; gastroesophageal reflux disease; proton pump inhibitors; Bulgaria

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