Cross-national changes in the effects of peptic ulcer disease

Article Abstract:

Ulcer disease has been changing over the past several decades. The most common location for ulcers was once the stomach; now the duodenum, the first part of the small intestine, is most frequently affected. What once affected mostly women and the young, now often strikes men and the elderly. An epidemiologic assessment of the changes in peptic ulcer disease was made by comparing and combining information from Belgium, the Federal Republic of Germany, The Netherlands, Sweden, the United Kingdom, and the United States, between 1970 and 1986. During this period, a new class of antiulcer drugs, known as H2 antagonists, was introduced, and their use appears to have had a significant effect on the course of peptic ulcer disease. Although mortality has declined in all countries, only in Germany has the mortality of peptic ulcer disease shown a significant decline. Hospitalization rates dropped markedly, and have continued to decline slowly. While the frequency of endoscopic examinations has risen, the frequency of operations to correct peptic ulcer disease has decreased dramatically, particularly in the United States and the United Kingdom. In addition, early retirement and time lost from work due to peptic ulcer disease have declined. An increased risk of complications, including death, from peptic ulcer disease has been noted in certain groups of patients, most notably in women over 65 years old. The introduction of the antiulcer H2 blockers has given rise to several of the positive trends noted in peptic ulcer disease, particularly the decrease in days lost from work and early retirement. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Germany, Mortality, Demographic aspects, Gastrointestinal diseases, Antiulcer agents, Antiulcer drugs

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Alternative management strategies for patients with suspected peptic ulcer disease

Article Abstract:

Using noninvasive antibiotic or antisecretory drug therapy along with a blood test for Helicobacter pylori (H. pylori) infection may be the most cost-effective way to initially manage patients with suspected stomach or intestinal ulcers. Researchers designed a computer model from the current medical literature that predicted the cost-effectiveness of 2 invasive and 3 noninvasive treatment choices for patients suspected of having ulcers with a possible H. pylori infection. They diagnosed and treated 1000 hypothetical patients with suspected ulcer disease with one of five treatment choices. Endoscopy, an invasive procedure that can visualize ulcers in the intestinal tract, may give an earlier and more precise diagnosis but may be nearly twice as expensive as conventional drug therapy. Blood tests for H. pylori reduced costs of additional antibiotic thereapy by 50%.

Research, Economic aspects, Medical care, Cost of, Health care costs, Helicobacter infections, Gastroscopy

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Internet Availability of Prescription Pharmaceuticals to the Public

Article Abstract:

Drugs purchased over the Internet may cost more and patients may not be able to check the qualifications of doctors who prescribe drugs online. In a survey of 46 Web sites offering drugs, 9 did not require a doctors' prescription or even a doctors' consultation. All 9 were located outside the US. The cost of a doctors' consultation over the Internet was 15% higher than the average for a visit to a general practitioner's office. The two most heavily promoted drugs were Viagra and a drug used to treat an enlarged prostate gland. Both were about 10% more expensive than the same drug bought at a pharmacy.

Drugs, Internet, Marketing, Investigations, Electronic commerce, E-commerce

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