Cost-benefit analysis of medicinal treatment for gastric ulcers. Long-term model including healing and recurrence.

Cost-benefit analysis (CBA) and cost-effectiveness analysis (CEA) are increasingly being used in medical practice and in health policy making. The choice among alternative treatments, the aim of a more efficient use of limited resources and the wider goal of cost containment, are so many reasons for CBA and CEA. This paper addresses the rather unexplored field of long-term cost-benefit analysis. Gastric ulcer, which is a recurrent disease is taken as a case study. Mathematical modelling is used for situation analysis of alternative long-term intervention strategies. The use of recurrence in the model makes the results of earlier CBA's based on the healing of a single episode, open to question. The paper holds important lessons for both the theoretical aspects of CBA and for its utilization in health policy formulation.