Long-term cost-effectiveness of medical, endoscopic and surgical management of gastroesophageal reflux disease

Funk, Luke M.; Zhang, James Y.; Drosdeck, Joseph M.; Melvin, W. Scott; Walker, John P.; Perry, Kyle A.

doi:10.1016/j.surg.2014.05.027

Cited by 49 publications

(42 citation statements)

References 46 publications

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“…Nissen fundoplication or low-cost PPIs alone have been shown to be cost-effective GERD treatment therapies compared to short-term TIF data [18]. This study shows that many patients require long-term PPI use post TIF associated with durable improvements in disease-specific quality of life, which could not be achieved with medication alone.…”

Section: Discussionmentioning

confidence: 87%

Long-term reported outcomes of transoral incisionless fundoplication: an 8-year cohort study

et al. 2018

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Section: Discussionmentioning

confidence: 87%

Long-term reported outcomes of transoral incisionless fundoplication: an 8-year cohort study

et al. 2018

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“…These results were consistent with the majority of modelingbased studies that reported GERD surgery as a cost-effective alternative to long-term maintenance therapy with PPIs. [23][24][25][26] Several trial-based economic evaluations also demonstrated anti-reflux surgery was a cost-effective treatment for GERD patients. [27][28][29] However, a few studies based on Markov modeling suggested PPI medication was preferred in terms of cost saving based on similar effectiveness.…”

Section: Discussionmentioning

confidence: 99%

“…27,32 Previous evidence has confirmed that anti-reflux surgery was quite costly, but annual post-surgical maintenance costs were constantly lower than medication therapy. [24][25][26]37 In our cost analysis using a claims database, the annual average medical costs for the surgery group continued to decline from $621.6 at the second year to $200.4 in the fifth year after anti-reflux surgery, whereas the medication group had a consistent cost of approximately $1300 per year for the 5 years of follow-up (data was not shown).…”

Section: Discussionmentioning

confidence: 99%

Anti-reflux Surgery Versus Proton Pump Inhibitors for Severe Gastroesophageal Reflux Disease: A Cost-Effectiveness Study in Korea

Park

Ryu

et al. 2020

J Neurogastroenterol Motil

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Background/Aims The economic burden for gastroesophageal reflux disease (GERD) has recently increased in Asian countries. This study investigates the cost-effectiveness between anti-reflux surgery and medication, with proton pump inhibitors (PPIs) for GERD in Korea. Methods We used a decision tree and Markov model to obtain the costs and quality-adjusted life years (QALYs) of the surgical and medical strategies. Our target cohort was the severe GERD patients aged 50 years old who required a continuous double dose of PPIs. The time horizon was 10 years and all estimates were discounted at 5% per year. The incremental cost-effectiveness ratio of the anti-reflux surgery compared with medication with PPIs was calculated. Sensitivity analyses were performed on all relevant variables. Results The cost-utility analysis indicated anti-reflux surgery was more cost-effective than medication among severe GERD patients over a 10year period. The model predicted that the surgical strategy had a cost savings of $551 and the QALYs had a gain of 1.18 as compared with the medical strategy. The break-even point in costs of the anti-reflux surgery over the medication was estimated to be 9 years. Sensitivity analyses using the varying parameter assumptions demonstrated the robustness of the study results. Conclusions This study showed anti-reflux surgery was less expensive and more effective therapy over the PPI medication after 9 years of follow-up. This suggests the surgical strategy is a cost-effective alternative to PPI medication among patients who need long-term management for GERD in Korea.

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“…PPIs are available at a low price, but when PPI therapy exceeds $90 per month, Nissen fundoplication and Stretta become more cost-effective (65).…”

Section: Discussionmentioning

confidence: 99%

Endoluminal treatment for gastroesophageal reflux disease

Campo

Perry

2015

Techniques in Gastrointestinal Endoscopy

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Long-term cost-effectiveness of medical, endoscopic and surgical management of gastroesophageal reflux disease

Cited by 49 publications

References 46 publications

Long-term reported outcomes of transoral incisionless fundoplication: an 8-year cohort study

Long-term reported outcomes of transoral incisionless fundoplication: an 8-year cohort study

Anti-reflux Surgery Versus Proton Pump Inhibitors for Severe Gastroesophageal Reflux Disease: A Cost-Effectiveness Study in Korea

Endoluminal treatment for gastroesophageal reflux disease

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