Over-the-scope clips are cost-effective in recurrent peptic ulcer bleeding

Area of Science:

• Gastroenterology
• Endoscopic Hemostasis
• Health Economics

Background:

• A prior randomized controlled trial (STING) demonstrated the superiority of over-the-scope clips (OSCs) over standard treatment for recurrent peptic ulcer bleeding.
• Cost-effectiveness studies specifically for OSCs in hemostasis have not been previously reported.

Purpose of the Study:

• To evaluate if the enhanced efficacy of OSC treatment justifies its higher device cost compared to standard clips.
• To determine the cost-effectiveness of OSCs for managing recurrent peptic ulcer bleeding.

Main Methods:

• The study utilized the patient population from the STING trial for cost-effectiveness analysis.
• Calculated average cost-effectiveness ratio (ACER) and incremental cost-effectiveness ratio (ICER) from the provider's perspective.
• Defined successful hemostasis without rebleeding within seven days as the primary outcome.

Main Results:

• Total costs per patient were not significantly different between standard and OSC groups (€13,007.07 vs €12,808.56).
• Treatment-related costs per patient also showed no significant difference (€2084.98 vs €1984.71).
• The ICER indicated that OSC treatment resulted in cost savings per successful hemostasis (-€468.18 for overall treatment, -€236.49 for hemostasis treatment alone).

Conclusions:

• Over-the-scope clip treatment is a cost-effective strategy for recurrent peptic ulcer bleeding.
• The findings suggest that OSCs provide economic benefits in addition to clinical advantages.