Economic evaluation of herbal versus antibiotic treatment in treating patients with Helicobacter pylori infection in the South of Iran: an analysis alongside a clinical trial

OBJECTIVES: Helicobacter pylori (H. pylori) infection is highly prevalent worldwide and affects more than half of the world's population. Various treatment regimens to eliminate H. pylori have been evaluated; however, selecting the most cost-effective regimen remains a challenge for clinicians. Therefore, the present study aimed at analyzing the cost-effectiveness of using different methods to treat H. pylori in southern Iran. METHODS: A cost-effectiveness analysis was conducted alongside a clinical trial that compared antibiotics versus herbal treatment in 132 patients with H. pylori referred to Shahid Motahari Clinic in Shiraz in 2020. A decision-tree model was developed to synthesize clinical and cost data. The patients were randomly divided into two groups, 64 of whom received an antibiotic regimen and 68 patients received a herbal treatment. The success rate of clinical trials in each treatment method was determined as the clinical outcome. This study was conducted from a societal perspective; therefore, direct and indirect costs were included. A data collection form was also used to collect the cost and effectiveness data. In addition, a one-way sensitivity analysis was performed to measure the robustness of the results. The data were analyzed using Tree Age Pro 2011 and Excel 2016 software. RESULTS: The results showed that antibiotic treatment was cheaper and more effective than herbal treatment and was the dominant strategy. The mean costs in the antibiotics and herbal treatment groups were $446.14 and $477.81, respectively, and the effectiveness was 62.5% and 38.2%. In addition, the one-way sensitivity analysis confirmed the robustness of the study results. CONCLUSION: The results showed that the use of antibiotics was a cost-effective and dominant strategy compared to herbal treatment and could be suggested as a better alternative to a wide range of patients with H. pylori infection. This conclusion is tempered by the short-term perspective, single-center design, and modest sample size of the study, highlighting the need for confirmatory long-term, multicenter research.