Little Cost Difference Among PPI Therapies for Bleeding Peptic Ulcers

Evidence strongly indicates that high-dose intravenous proton-pump inhibitor (PPI) therapy improves clinical outcomes in patients with bleeding peptic ulcers and endoscopic high-risk stigmata for rebleeding with or without endoscopic therapy. Though not shown to improve major clinical outcomes, pre-endoscopy administration of high-dose PPI therapy has been demonstrated to decrease the prevalence of high-risk stigmata and the need for endoscopic therapy at subsequent endoscopy. Intermittent bolus therapy has been suggested as an alternative approach with similar efficacy.

To examine the costs of different approaches to PPI delivery in this setting, investigators used a decision analysis model to compare four dosing/timing regimens — intraveno…