Kengo Tokunaga 1Chihiro Suzuki 2Miyuki Hasegawa 2Ikuo Fujimori 21Department of General Medicine,Kyorin University School of Medicine,Tokyo, Japan; 2Japan Medical Office,Takeda Pharmaceutical Company Limited,Tokyo, Japan Correspondence: Kengo TokunagaDepartment of General Medicine, KyorinUniversity School of Medicine, 6-20-2Shinkawa, Mitaka-Shi, Tokyo, 181-8611,JapanTel +81-422-47-5511Email kentoku@ks.kyorin-u.ac.jp Objective: Cost-benefit is an important consideration for Helicobacter pylori (H. pylori)eradication in Japan, where 1.5 million patients were reported to receive first-line eradicationannually. This study aimed to identify the optimal cost-saving triple therapy regimen forH. pylori eradication in Japan.Materials and Methods: This retrospective observational study used data from a largescale,nationwide health insurance claims database (2015â2018). Using success rates of first-lineeradication, mean total costs of first-line and second-line eradications per patient werecompared between regimens including a potassium-competitive acid blocker (P-CAB) ora proton pump inhibitor (PPI), and between two clarithromycin (CAM) doses (400 and800 mg/day). Subgroup analyses by smoking habit or body mass index (BMI) wereperformed.Results: Among propensity score (age, gender, CAM dose, disease name)-matched patients(P-CAB regimen, n=22,002; PPI regimen, n=22,002), total costs were lower with the P-CABthan the PPI regimen (Japanese yen [JPY] 12,952 vs 13,146) owing to significantly higherfirst-line eradication rates with the P-CAB regimen (93.6% vs 79.7%; p
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