Cost analysis of breath test versus endoscopy for dyspepsia

Background. There is currently much debate on the best way to manage dyspepsia in the community and cost effectiveness is often discussed. We aim to perform a cost analysis of a test and treat strategy for Helicobacter pylori versus endoscopy using data based on the breath test service in Leicester. Methods: Retrospective analysis of data acquired over the 1-year period from March 1, 1999, to February 29, 2000, in a university teaching hospital. The main outcome measure was the cost of each management strategy. Results: Referral to the breath test service cost pound84.67 per person with dyspepsia (including treatment of positive patients and endoscopy cost of patients endoscoped). If the breath test service had not existed, referral for endoscopy would have cost pound98.35 per person. This equates to a cost saving of pound8,276 over the year studied for the 605 patients referred. It also resulted in 353 fewer endoscopies being performed. Conclusion: Direct referral to a H. pylori breath test service saves money, avoids an unpleasant test for many people and reduces the endoscopy waiting list.