Anti-reflux Surgery Versus Proton Pump Inhibitors for Severe Gastroesophageal Reflux Disease: A Cost-Effectiveness Study in Koreaopen access
- Authors
- Park, Susan; Park, Sungsoo; Park, Joong-Min; Ryu, Soorack; Hwang, Jinseub; Kwon, Jin-Won; Seo, Kyung Won
- Issue Date
- Apr-2020
- Publisher
- KOREAN SOC NEUROGASTROENTEROLOGY & MOTILITY
- Keywords
- Quality-adjusted life years; Cost of illness; Gastroesophageal reflux disease; Proton pump inhibitors
- Citation
- JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY, v.26, no.2, pp 215 - 223
- Pages
- 9
- Journal Title
- JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY
- Volume
- 26
- Number
- 2
- Start Page
- 215
- End Page
- 223
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/42866
- DOI
- 10.5056/jnm19188
- ISSN
- 2093-0879
2093-0887
- Abstract
- 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 10-year 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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