A Comparison of the Cost Effectiveness of Pharmacotherapy or Surgery (Laparoscopic Fundoplication) in the Treatment of GORD

Abstract

The results of the model suggest that, on the basis of current evidence, laparoscopic fundoplication represents a cost effective means of treating GORD rather than lifelong medical management.

Clinical and economic evaluation of laparoscopic surgery compared with medical management for gastro-oesophageal reflux disease: 5-year follow-up of multicentre randomised trial (the REFLUX trial)

“…These were published as part of the earlier HTA report 1 and in two journal articles. 3,5 Summaries of the two within-trial economic evaluations are presented in Appendix 7. Below is a brief description of the eight reports -the five linked to the three randomised trials are considered first, followed by the three studies based on observational data.…”

“…Economic evaluation based on the REFLUX trial 1,3,5 Bojke et al 5 present a preliminary cost-effectiveness analysis conducted before the availability of the 1-year REFLUX trial results. The analysis compared the cost-effectiveness of surgery (laparoscopic fundoplication) with long-term medical management (PPIs) for GORD disease in an average 45-year-old man.…”

“…The first stage, encompassing preliminary economic modelling, outcome development, trial recruitment, initial clinical management, follow-up to a time equivalent to 1 year after surgery and modelling of cost-effectiveness based on results available at that time, was reported in 2008. [1][2][3][4][5] The second stage, reported here, describes analyses based on further follow-up to 5 years after surgery.…”

Outcomes of different treatment opproaches for gastro-oesophageal reflux disease

“…Hypothetical Markov models seem to support this notion 47 . However, in a randomized controlled study comparing anti-re£ux surgery with omeprazole, 5-year direct medical costs were signi¢cantly lower for medical therapy than surgery.…”

Estudo da expressão das proteínas juncionais e dos fatores inflamatórios em pacientes com doença do refluxo gastroesofágico erosiva e não erosiva

“…A doença do refluxo gastroesofágico (DRGE), a qual é induzida pelo refluxo dos conteúdos gastrico e duodenal para o esôfago, recentemente vem sendo reconhecida como sério problema clínico pela sua elevada e crescente prevalência (Betarello et al 1987;Moraes-Filho JPP, 2004) e por afetar de modo significativo a qualidade de vida do paciente, seja à custa da sintomatologia ou das restrições dietético-comportamentais, seja pelo uso freqüente da terapia medicamentosa (Coley et al 1993;Bojke et al 2007).…”