Gastric Ulcer Treatment Market By Treatment Type (Proton Pump Inhibitors, Potassium-Competitive Acid Blockers, H2-Receptor Antagonists, Antibiotic Combination Therapies, Bismuth-Based Therapies, Mucosal Protective Agents, Antacids, Endoscopic Treatment, Surgical Treatment); By Application (Helicobacter pylori-Associated Gastric Ulcers, NSAID-Induced Gastric Ulcers, Bleeding Gastric Ulcers, Refractory Gastric Ulcers, Recurrent Gastric Ulcers, Perforated Gastric Ulcers, Stress-Related Gastric Ulcers); By End User (Hospitals, Gastroenterology Clinics, Ambulatory Endoscopy Centers, Primary Care Clinics, Retail Pharmacies, Hospital and Specialty Pharmacies); By Geography, Segment Revenue Estimation, Forecast, 2026–2032

Gastric Ulcer Treatment Market: Resistance-Aware H. pylori Therapy, Follow-Up Care, and Payer Access Redirect Revenue

The Global Gastric Ulcer Treatment Market was valued at USD 5.63 billion in 2025 and is projected to reach USD 8.57 billion by 2032, growing at a CAGR of 6.2%, according to Strategic Market Research.

 

The Gastric Ulcer Treatment Market is shifting from a largely generic prescription category toward a broader care pathway that includes resistance-aware Helicobacter pylori treatment, newer acid-suppression products, eradication testing, repeat endoscopy, and hospital care for complications. Proton pump inhibitors and established antibiotic regimens still account for most routine treatment volume. Revenue growth is concentrating in patients who require branded therapy, additional testing, specialist intervention, or acute care.

 

Public databases rarely isolate gastric ulcers from duodenal, unspecified, and gastrojejunal ulcers. Epidemiological studies generally report peptic ulcer disease, while company disclosures often combine H. pylori products with medicines approved for other gastrointestinal conditions. Broader peptic-ulcer statistics and mixed-indication product sales indicate treatment activity but should not be treated as standalone gastric-ulcer market values.

 

Ageing Is Offsetting the Decline in Standardized Ulcer Rates

The National Institute of Diabetes and Digestive and Kidney Diseases estimates that peptic ulcers affect 1% to 6% of the U.S. population. A Global Burden of Disease analysis estimated approximately 8.09 million prevalent peptic-ulcer cases worldwide in 2019. The absolute number of cases increased by 25.82% from 1990 even as age-standardized prevalence declined. Population growth and ageing are maintaining the number of patients entering treatment rather than producing uniform incidence growth.

Hospital demand remains substantial despite long-term improvements in prevention and outpatient management. An analysis of 36 OECD countries estimated approximately 329,000 peptic-ulcer hospitalizations for 2021. Country rates ranged from 3.5 hospitalizations per 100,000 people in Mexico to 92.1 per 100,000 in Lithuania. Differences in H. pylori prevalence, analgesic exposure, outpatient access, coding practices, and endoscopy availability prevent suppliers from using a single global hospitalization rate for commercial planning.

Older adults account for the highest-cost treatment episodes. The United States recorded 3,850 peptic-ulcer deaths in 2023, and gastric ulcers were the largest anatomical mortality subtype identified in the study. Mortality reached 14.71 per 100,000 among people aged 85 and older, compared with an overall age-adjusted rate of 1.78. Hospitals, gastroenterology practices, endoscopy centers, and Medicare plans therefore carry a concentrated burden among elderly patients with multiple illnesses and higher complication risk.

 

Antibiotic Resistance Is Changing the H. pylori Revenue Mix

H. pylori eradication remains one of the largest identifiable treatment groups connected with gastric ulcers. A global meta-analysis covering 111 countries estimated that adult infection prevalence declined from 52.6% before 1990 to 43.9% during 2015–2022. Only a minority of infected patients develop gastric ulcers, but the remaining infection pool continues to support testing, prescribing, treatment confirmation, and retreatment.

The 2024 American College of Gastroenterology guideline changed the commercial position of several established regimens. Optimized bismuth-based quadruple therapy for 14 days is preferred for many treatment-naïve patients. Clarithromycin triple therapy should generally be avoided unless susceptibility testing confirms that the infection remains sensitive to clarithromycin.

Generic proton pump inhibitors, antibiotics, and bismuth products benefit from the preference for multi-drug eradication therapy. Branded combination products gain a narrower but higher-value opportunity among patients with previous antibiotic exposure, treatment failure, adherence concerns, or limited suitable alternatives. Resistance is therefore redistributing prescriptions rather than simply expanding the total number of treated patients.

Failed eradication produces another prescription event, further testing, and additional physician visits. Patients who do not respond to an initial regimen may move from primary care to gastroenterology practices, where specialist evaluation, alternative treatments, and endoscopy become more likely. Suppliers with evidence in difficult-to-treat infections can defend value more effectively than products competing only on familiarity.

 

Generic Proton Pump Inhibitors Retain Volume While New Acid Suppressants Capture Premium Prescriptions

Proton pump inhibitors remain the pharmaceutical foundation of gastric-ulcer treatment. Low prices, broad reimbursement, extensive generic availability, and physician familiarity protect their use in H. pylori-associated ulcers, NSAID-associated ulcers, and patients requiring ongoing acid suppression. H2-receptor antagonists retain a smaller role among patients who cannot use or do not respond adequately to proton pump inhibitors.

Potassium-competitive acid blockers have introduced a premium prescription category above this generic base. The FDA approved VOQUEZNA Triple Pak and Dual Pak for adult H. pylori infection after a study involving 992 adults at 103 sites in six countries. The approval expanded the number of branded, cause-targeted options available to U.S. gastroenterologists.

Phathom Pharmaceuticals reported more than 1.1 million cumulative VOQUEZNA prescriptions by February 2026 and USD 175.1 million in 2025 net revenue. Cumulative prescriptions reached approximately 1.35 million by April 17, 2026, while first-quarter revenue totaled USD 58.3 million. Insurance covered approximately 63% of prescriptions filled during the quarter.

VOQUEZNA disclosures include H. pylori, erosive gastroesophageal reflux disease, and other approved uses. The reported revenue cannot be assigned entirely to gastric-ulcer treatment. Prescription growth still demonstrates that differentiated acid suppression can reach meaningful commercial scale when clinical positioning is supported by gastroenterology promotion and reimbursement.

Generic proton pump inhibitors will continue to control broad treatment volume. Newer branded therapies are more likely to gain revenue in selected patients, insured populations, bundled eradication regimens, and specialist practices than through widespread replacement of inexpensive generic products.

 

NSAID Exposure Protects a Large Generic Treatment Base

Nonsteroidal anti-inflammatory drug use maintains gastric-ulcer demand even as H. pylori prevalence declines. Older adults and patients receiving long-term pain treatment are particularly exposed. Some patients cannot permanently discontinue the medicine associated with ulcer formation, creating continued demand for acid suppression and clinical monitoring.

NICE recommends stopping NSAID therapy where possible after a peptic-ulcer diagnosis and providing full-dose proton pump inhibitor or H2-receptor antagonist treatment for eight weeks. Patients who must continue an NSAID may require an alternative analgesic strategy and accompanying proton pump inhibitor protection.

Primary-care practices, retail pharmacies, generic manufacturers, and public drug programs capture most of this volume. Unlike H. pylori treatment, NSAID-associated prescribing does not depend on antibiotic susceptibility or eradication testing. Revenue follows chronic analgesic use, patient age, previous ulcer history, and the use of preventive acid suppression in high-risk patients.

Pricing remains constrained because the main therapies are widely available as generics. Manufacturers compete through supply reliability, formulary inclusion, wholesaler relationships, and tender access rather than strong product differentiation.

 

Follow-Up Testing and Endoscopy Increase Revenue per Diagnosed Patient

Gastric-ulcer treatment often extends beyond the initial prescription. NICE recommends repeat endoscopy six to eight weeks after treatment begins for relevant patients with gastric ulcers and H. pylori. Clinicians use follow-up procedures to confirm healing and investigate lesions that remain unresolved.

An unhealed ulcer can lead to additional biopsy, imaging, medication changes, adherence assessment, specialist consultations, or another eradication course. Gastroenterology practices and endoscopy centers therefore capture a larger share of gastric-ulcer spending than pharmaceutical sales alone indicate.

The American College of Gastroenterology also recommends confirmation of H. pylori eradication at least four weeks after treatment. Breath tests, stool antigen tests, and biopsy-based confirmation create another billable event around the treatment course.

Healthcare systems with consistent follow-up pathways record expenditure across diagnosis, medicines, eradication confirmation, repeat endoscopy, and retreatment. Systems with limited specialist capacity may have a large disease burden but lower recorded spending per patient because testing and healing confirmation are less consistently completed.

Diagnostic laboratories and procedural providers benefit from treatment guidelines even when medicine prices remain under pressure. Pharmaceutical suppliers also benefit indirectly because reliable follow-up identifies treatment failure and creates demand for another regimen.

 

Complications Preserve High-Value Institutional Demand

Bleeding, perforation, obstruction, and ulcers that fail to heal affect fewer patients than uncomplicated disease but account for much higher spending per episode. Treatment can require emergency evaluation, inpatient medicines, transfusion, endoscopy, imaging, monitoring, or surgery.

The estimated 329,000 peptic-ulcer hospitalizations across 36 OECD countries confirm a substantial institutional treatment base despite falling admission rates. Acute episodes are largely non-discretionary, making hospital demand less sensitive to promotional activity or consumer purchasing power.

Endoscopic intervention has replaced surgery in many bleeding cases, but surgical care remains necessary when medical and endoscopic management fails. Revenue is distributed across hospitals, endoscopy centers, procedure suppliers, laboratories, imaging providers, and specialist teams rather than captured by one pharmaceutical company.

Older adults remain the main high-resource group because they have greater exposure to ulcer-associated medicines, more comorbidities, and a higher risk of severe outcomes. Ageing populations can therefore support hospital and monitoring revenue even where national ulcer incidence is falling.

 

Formulary Decisions Determine Whether Branded Products Convert Clinical Need into Sales

Generic gastric-ulcer medicines generally have broad coverage and low acquisition costs. Branded H. pylori therapies face formulary review, rebate negotiations, prior treatment requirements, and competition from low-cost multi-drug regimens.

CMS Medicare Part D data recorded 2,015 Talicia prescribers, 4,146 claims, and approximately USD 3.33 million in total drug cost during 2023. The claims cover H. pylori treatment and do not identify the number of gastric-ulcer patients, but they provide a transparent measure of reimbursed branded utilization among Medicare beneficiaries.

RedHill Biopharma reported approximately USD 8.9 million in U.S. Talicia revenue during 2025 and about USD 1.9 million from licensing, product supply, and royalties outside the United States. Humana later added Talicia coverage for more than eight million Medicare lives. The formulary addition expanded the reachable insured population without requiring an increase in disease prevalence.

Commercial reach is equally important. Cumberland Pharmaceuticals invested USD 4 million for a 30% interest in the Talicia business and assumed a major role in U.S. commercialization and distribution. The partnership reflects the sales coverage, payer capability, and pharmacy access required for a specialist product competing against generic alternatives.

Branded suppliers with limited payer access may generate strong clinical interest without achieving comparable prescription volume. Products supported by insurer contracts, gastroenterology-focused sales teams, and established distribution networks are better positioned to convert diagnosed patients into reimbursed prescriptions.

 

Regional Revenue Follows Treatment Access Rather than Disease Burden Alone

The United States provides the clearest public evidence on branded prescribing, payer spending, company revenue, and formulary access. Medicare exposure, specialist gastroenterology capacity, retail pharmacy distribution, and extensive endoscopy infrastructure create a developed treatment pathway. Older-patient complications support institutional spending, while branded outpatient growth depends on insurance coverage.

North America provides the clearest evidence of branded treatment adoption, reimbursement access, and supplier performance in the gastric-ulcer treatment market.

European demand is more closely linked to national guidance, public procurement, and generic pricing. NICE directs prescribers toward the lowest-cost suitable H. pylori regimen while maintaining repeat endoscopy and retesting for relevant gastric-ulcer patients. Pharmaceutical pricing remains constrained, but structured follow-up sustains diagnostic and procedural activity.

European hospitalization rates vary substantially by country. National market revenue depends on infection prevalence, medicine procurement, endoscopy capacity, reimbursement policy, and clinical guidance.

Asia-Pacific combines high H. pylori prevalence in several countries with large differences in diagnosis, insurance coverage, and specialist access. A 2024 meta-analysis estimated H. pylori prevalence in China at 42.8% during 2014–2023, although rates varied substantially by region, age group, and testing method.

Japan demonstrates how broad eradication access can reduce long-term treatment volume. National survey data showed peptic-ulcer cases falling from approximately 164,300 in 1984 to 34,600 in 2014. Mature Asian markets are therefore more dependent on replacement prescribing, premium therapy, follow-up care, and older-patient complications than rising incidence.

Developing Asian markets may have larger untreated infection pools but lower spending per patient. Generic medicines and public programs are likely to control volume, while branded products concentrate initially in insured urban populations and private gastroenterology practices.

 

Suppliers Capture Value Through Price, Access, or Treatment Differentiation

Generic manufacturers compete through low prices, stable supply, tender participation, wholesaler relationships, and broad pharmacy distribution. Their product base includes proton pump inhibitors, H2-receptor antagonists, antibiotics, and bismuth therapies. Limited pricing power is offset by large prescription volumes and recurring procurement.

Branded gastrointestinal companies require differentiated clinical evidence, payer contracts, specialist promotion, and treatment formats that justify a higher reimbursed cost. Phathom’s VOQUEZNA franchise demonstrates the potential scale of a broader branded acid-suppression platform. RedHill and Cumberland illustrate the commercial investment needed to expand a more narrowly focused H. pylori product.

Laboratories, hospitals, and endoscopy providers capture revenue that medicine-only assessments overlook. Eradication confirmation, healing assessment, treatment failure, and complication management connect pharmaceutical care with diagnostics and procedures.

Routine gastric-ulcer prescriptions will remain heavily generic and price-sensitive. Resistance-aware H. pylori treatment, insured branded therapies, newer acid suppressants, diagnostic confirmation, repeat endoscopy, and complication care will account for a larger share of revenue growth. Suppliers with strong payer access, specialist reach, reliable distribution, and evidence in difficult-to-treat patients are positioned to capture more value than companies relying only on broad ulcer prevalence or low-cost drug supply.

 

Report Coverage Table

Report Attribute	Details
Forecast Period	2026 – 2032
Market Size Value in 2025	USD 5.63 Billion
Revenue Forecast in 2032	USD 8.57 Billion
Overall Growth Rate	CAGR of 6.2% (2026 – 2032)
Base Year for Estimation	2025
Historical Data	2019 – 2024
Unit	USD Million, CAGR (2026 – 2032)
Segmentation	By Treatment Type, By Application, By End User, By Geography
By Treatment Type	Proton Pump Inhibitors, Potassium-Competitive Acid Blockers, H2-Receptor Antagonists, Antibiotic Combination Therapies, Bismuth-Based Therapies, Mucosal Protective Agents, Antacids, Endoscopic Treatment, Surgical Treatment
By Application	Helicobacter pylori-Associated Gastric Ulcers, NSAID-Induced Gastric Ulcers, Bleeding Gastric Ulcers, Refractory Gastric Ulcers, Recurrent Gastric Ulcers, Perforated Gastric Ulcers, Stress-Related Gastric Ulcers
By End User	Hospitals, Gastroenterology Clinics, Ambulatory Endoscopy Centers, Primary Care Clinics, Retail Pharmacies, Hospital and Specialty Pharmacies
By Region	North America, Europe, Asia-Pacific, Latin America, Middle East and Africa
Country Scope	U.S., Canada, UK, Germany, France, Italy, China, Japan, South Korea, India, Brazil, Mexico, Saudi Arabia, UAE, South Africa
Market Drivers	Rising Helicobacter pylori treatment volumes, growing NSAID-associated ulcer burden, wider use of acid suppression therapies, increasing endoscopic diagnosis rates, aging patient pool, and expanding access to gastroenterology care
Customization Option	Available upon request