Ulcers[1] are holes or tears in the lining of the digestive tract. They can affect the stomach, intestines, or, more rarely, the esophagus. Most are the product[2] of infections caused by H. pylori., bacteria that live and grow in the stomach, but other factors, such as smoking or abuse of over-the-counter painkillers, may also encourage their development. It is estimated that one in 10 Americans will experience an ulcer in their lifetime.
Typical costs:
Patients seeking medical attention for an ulcer would start with an office visit to a primary doctor, which is typically covered by health insurance. For patients covered by health insurance, out-of-pocket costs typically consist of a copay of $10-$50 or more, or coinsurance of 10%-50% or more. For patients without health insurance, an office visit typically costs $50-$200 or more.
Ulcer treatment typically centers on drug therapy. The standard treatment for an ulcer caused by H. pylori is a two-week drug regimen called triple therapy[3] that includes the antibiotic clarithromycin, a proton pump inhibitor, and the antibiotics amoxicillin or metronidazole. According to the University of Michigan Health System[4] , the cost of triple therapy can range from $279-$672. For patients covered by health insurance, the typical out-of-pocket cost for drugs is a prescription drug copay that can range from $5- $30 or more. Some patients need to take more than one round of triple therapy to clear H. pylori bacteria.
Several other medicines may also be prescribed, including H-2-receptor blockers such as ranitidine (Zantac), which typically costs $24 for 150 mg of the generic drug and $273 for the same amount of the brand name drug, and prescription-strength proton pump inhibitors such as lansoprazole (Prevacid)[5] , which costs $175 a month for 15 mg of the generic drug and $212 for the same amount of the brand name version.
Over-the-counter antacids[6] may help to alleviate pain caused by ulcers and typically cost $4-$25 depending on the quantity and whether the patient buys a name brand or its generic equivalent. For example, 150 tablets of Tums[7] costs $5-$6. Insurers do not typically pay for nonprescription medicines.
Patients who experience the symptoms[8] of an ulcer would typically start by seeing a family doctor or a general practitioner. According to the American Academy of Family Physicians[9] , a doctor may put a patient on medicine before running tests, since ulcers typically feel better within several days of starting treatment. A primary doctor may also refer a patient to a gastroenterologist.
Treatment[10] will be aimed at getting rid of the H. pylori bacteria, lowering the level of stomach acid, or neutralizing stomach acid and protecting injured areas. Treatment typically includes either three or four drugs.
According to the National Institute of Diabetes and Digestive and Kidney Diseases[11] at least four weeks after treatment, patients will be given a breath or stool test to see if the H. pylori infection has been cured. If infection is still present, patients may be given a second round of treatment with different antibiotics than those initially used.
Additional costs:
In some instances, surgery may be needed if the ulcer has created a hole in the stomach wall or caused serious bleeding. At Saint Elizabeth Regional Medical Center[12] in Lincoln, NE, the average cost of surgery for an ulcer is $13,579.
Discounts:
Outlets such as Costco[13] and Walmart[14] often sell prescription and over-the-counter drugs at significant savings. Walmart, for example, has a prescription drug program[15] that includes certain generic drugs at commonly prescribed dosages.
Many hospitals offer discounts of 30% of more to uninsured/cash-paying patients. At St. Joseph Hospital[16] in Orange, CA, for example, patients without health insurance may qualify for a 45% discount off billed charges. They'll also be offered an additional 10% discount if payment is made within 10 days of receiving a bill.
Shopping for ulcer treatment:
The American College of Gastroenterology offers a physician locator[17] .
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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