Drug Information Q&A Q43. Can drugs reduce the financial burden on patients?

Answer

Pharmaceuticals can help prevent and treat diseases, as well as shorten the duration of treatment and reduce the risk of recurrence. As such, they play a major role in reducing the economic burden of patients associated with diseases and national healthcare costs.

Explanation

Preventing illnesses through drugs and preventing recurrence or worsening of illnesses even if they do occur can help reduce the physical and mental burden on the patients themselves.

But not only that, it is also very significant in terms of reducing the burden of medical costs. A typical example is the eradication of H. pylori with proton pump inhibitors (PPIs) and antibacterial agents.

The treatment of peptic ulcers became very successful with H2 blockers and PPIs (see Q42). However, it was later confirmed that there is a risk of recurrence of peptic ulcers that should have been cured if Helicobacter pylori (H. pylori) bacteria remain in the stomach. As of 2011, 30% of Japanese people in their 40s and 45% of Japanese people in their 50s are said to have H. pylori. As long as these bacteria are present, peptic ulcers cannot be considered completely cured.

Research has therefore been conducted to eliminate H. pylori, and eradication therapy combining PPIs and antibacterial drugs is now used. This method has greatly reduced the risk of peptic ulcer recurrence.

At the same time, the cost of medical care can be reduced by less than half from the initial treatment to five years after healing (including the cost of treatment for recurrent ulcers) when PPIs and antibacterial agents are used for eradication of H. pylori compared to the use of conventional drugs for peptic ulcer treatment. The development of new drugs and the establishment of new treatment methods have also contributed to significantly reducing the burden of medical costs.

Immunosuppressive drugs, which are indispensable for organ transplantation, have also advanced the therapeutic technique of organ transplantation, shortened hospital stays, and reduced the burden of medical costs.

For example, the immunosuppressant drug cyclosporine, introduced in the 1980s, not only dramatically increased transplant success rates, but also facilitated postoperative management and shortened hospital stays. The average hospital stay for renal transplant patients (cadaveric kidney transplant) is reduced to 26.4 days with cyclosporine, compared to 37.0 days without cyclosporine. The use of cyclosporine reduces the length of hospital stay, which in turn reduces healthcare costs.

In addition to efficacy and safety, the drug is also recognized for its value from an economic standpoint.

Chart/Column

Peptic Ulcer Drugs

Comparison of medical costs (gastric ulcer and duodenal ulcer)

As of December 2023

Medical costs are direct medical costs from the initial treatment of ulcers to five years after healing. Conventional therapy includes "Famotidine"; eradication therapy includes "Lansoprazole," "Amoxicillin," and "Clarithromycin.

Source: Ikeda S. et al.: Evaluation of the cost-effectiveness pylori eradication triple therapy vs. conventional therapy for ulcers in Japan Alment Adapted from Pharmacol Ther 15: 1777-85, 2001 Chapter 6

MINI Column Eradication therapy for H. pylori

The most common method of eradication therapy for H. pylori is a combination of a PPI and two antibacterial drugs, taken for about one week in a row. The treatment of peptic ulcers (stomach and duodenal ulcers) is covered by public insurance. Eradication therapy significantly reduces the risk of recurrence of peptic ulcers.

In addition to causing peptic ulcers, H. pylori is also a cause of gastric cancer. A study conducted by the Ministry of Health, Labour and Welfare of Japan on patients with precancerous conditions caused by chronic gastritis found that eradication of H. pylori was associated with better improvement of precancerous conditions than no treatment at all.

For example, in the case of atrophic gastritis in the lower part of the stomach, one of the precancerous conditions, the eradication of H. pylori resulted in a 62% improvement rate compared to 15% in the absence of eradication.

Therefore, eradication therapy for H. pylori is expected to have the effect of inhibiting the progression of gastric cancer.

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