Cost-effectiveness of proton pump inhibitors versus laparoscopic Nissen fundoplication for patients with gastroesophageal reflux disease: a systematic review of the literature

Thijssen, Anthony S.; Broeders, I. A. M. J.; Wit, G. Ardine de; Draaisma, Werner A.

doi:10.1007/s00464-011-1689-y

Cited by 10 publications

(7 citation statements)

References 34 publications

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“…Also, wide variability in outcomes has limited the adoption of this procedure [Richter and Dempsey, 2008;Vakil et al 2003]. A Cochrane analysis found that laparoscopic fundoplication surgery is more effective than medical management for the treatment of GERD in short-to medium-term follow up [Wileman et al 2010], although studies on the cost effectiveness of Nissen fundoplication versus pharmacological therapy with PPIs have been largely inconclusive [Thijssen et al 2011].…”

Section: Comparison Of Current Therapeutic Options For Gastroesophagementioning

confidence: 99%

LINX^® Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux

Bonavina

Saino

Lipham

et al. 2013

Therap Adv Gastroenterol

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Gastroesophageal reflux disease (GERD) results from incompetency of the lower esophageal sphincter that allows the contents of the stomach to reflux into the esophagus, the airways, and the mouth. The disease affects about 10% of the western population and has a profound negative impact on quality of life. The majority of patients are successfully treated with proton-pump inhibitors, but up to 40% have incomplete relief of symptoms even after dose adjustment. The laparoscopic Nissen fundoplication represents the surgical gold standard, but is largely underused because of the level of technical difficulty and the prevalence of side effects. These factors have contributed to the propensity of patients to continue with medical therapy despite inadequate symptom control and complications of the disease. As a consequence, a significant 'therapy gap' in the treatment of GERD remains evident in current clinical practice. The LINX ® Reflux Management System (Torax Medical, St. Paul, MN, USA) is designed to provide a permanent solution to GERD by augmenting the sphincter barrier with a standardized, reproducible laparoscopic procedure that does not alter gastric anatomy and is easily reversible. Two single-group trials confirmed that a magnetic device designed to augment the lower esophageal sphincter can be safely and effectively implanted using a standard laparoscopic approach. The device decreased esophageal acid exposure, improved reflux symptoms and quality of life, and allowed cessation of proton-pump inhibitors in the majority of patients.

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Section: Comparison Of Current Therapeutic Options For Gastroesophagementioning

confidence: 99%

LINX^® Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux

Bonavina

Saino

Lipham

et al. 2013

Therap Adv Gastroenterol

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“…As the goal is improved quality of life, the increased in cost should be offset by a distinct gain in symptom control and/or decrease in health‐care resource utilization. A review of available data concluded that studies addressing cost‐effectiveness of operative and medical therapy for patients with gastroesophageal reflux are inconclusive . Modeling studies including quality of life changes point at a potential for cost savings only if the symptomatic benefit persists .…”

Section: Discussionmentioning

confidence: 99%

“…A review of available data concluded that studies addressing cost-effectiveness of operative and medical therapy for patients with gastroesophageal reflux are inconclusive. 39 Modeling studies including quality of life changes point at a potential for cost savings only if the symptomatic benefit persists. 40 However, current evidence indicates that most patients will continue or restart acid suppressive medication after surgery.…”

Section: Discussionmentioning

confidence: 99%

Fundoplication for gastroesophageal reflux disease: regional variability and factors predicting operative approach

Nusrat

Bielefeldt

2013

Dis Esophagus

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We have recently shown that the majority of patients undergoing fundoplication in the United States are women. Based on these findings, we hypothesized that nonbiological factors contribute to the decisions on surgical reflux therapy. Using State Inpatient Databases of the Agency for Healthcare Research and Quality, we extracted annual fundoplication rates, sex distribution, age cohorts, racial background, and insurance coverage. To account for potential differences in state populations, the results were normalized and correlated with Census data, adult obesity rates, median income, poverty rates, and physician workforce within the state. Fundoplication rates varied fivefold between states, ranging from 4.1±0.1 per 100,000 in New Jersey to 21.8±0.4 per 100,000 in Oregon. Higher poverty rates and a higher fraction of Caucasians within a state independently predicted higher fundoplication rates. While the majority of operations were performed laparoscopically, surgical approaches also differed between states with rates of laparoscopic ranging from 52.3±1.8% in Oklahoma to 87.4±1.7% in Hawaii. A lower number of pediatric and Medicaid-insured patient and a higher fraction of privately insured patients best predicted higher rates of laparoscopic surgery. Our study shows significant regional variation in surgical reflux management, which cannot be explained by differences in disease mechanisms. Insurance coverage and racial background influenced the likelihood of surgery, suggesting a role of financial incentives.

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“…Surgery also eliminates the concern for patient compliance with medical therapy, and may reduce the cost of treatment compared with life-long antisecretory therapy. 15 Approach to Antireflux Surgery for Barrett's Esophagus…”

Section: Benefits Of Antireflux Surgerymentioning

confidence: 99%

Surgical Management of Barrett’s Esophagus

Peyré

Watson²

2015

Gastroenterology Clinics of North America

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Cost-effectiveness of proton pump inhibitors versus laparoscopic Nissen fundoplication for patients with gastroesophageal reflux disease: a systematic review of the literature

Abstract: The results with regard to cost-effectiveness are inconclusive. All four economic models are based on high- and low-quality data. More reliable estimates of cost-effectiveness based on long-term trial data are needed.

Cited by 10 publications

References 34 publications

LINX^® Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux

LINX^® Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux

Fundoplication for gastroesophageal reflux disease: regional variability and factors predicting operative approach

Surgical Management of Barrett’s Esophagus

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Cost-effectiveness of proton pump inhibitors versus laparoscopic Nissen fundoplication for patients with gastroesophageal reflux disease: a systematic review of the literature

Abstract: The results with regard to cost-effectiveness are inconclusive. All four economic models are based on high- and low-quality data. More reliable estimates of cost-effectiveness based on long-term trial data are needed.

Cited by 10 publications

References 34 publications

LINX® Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux

LINX® Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux

Fundoplication for gastroesophageal reflux disease: regional variability and factors predicting operative approach

Surgical Management of Barrett’s Esophagus

Contact Info

Product

Resources

About

LINX^® Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux

LINX^® Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux