Diagnosis and treatment of patients with gastroesophageal reflux disease - a systematic review of cost-effectiveness and economic burden
Language English Country England, Great Britain Media electronic
Document type Journal Article, Systematic Review
Grant support
grant agreement no. 101057525, project eCAP
European Union's Horizon Europe Research and Innovation
grant agreement no. 101057525, project eCAP
European Union's Horizon Europe Research and Innovation
grant agreement no. 101057525, project eCAP
European Union's Horizon Europe Research and Innovation
grant agreement no. 101057525, project eCAP
European Union's Horizon Europe Research and Innovation
grant agreement no. 101057525, project eCAP
European Union's Horizon Europe Research and Innovation
PubMed
39501242
PubMed Central
PMC11539747
DOI
10.1186/s12913-024-11781-8
PII: 10.1186/s12913-024-11781-8
Knihovny.cz E-resources
- Keywords
- Cost-effectiveness, Diagnostic methods, Gastroesophageal reflux disease, Gastrointestinal diseases,
- MeSH
- Cost-Benefit Analysis * MeSH
- Gastroesophageal Reflux * diagnosis therapy economics drug therapy MeSH
- Proton Pump Inhibitors * therapeutic use economics MeSH
- Humans MeSH
- Cost of Illness MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Systematic Review MeSH
- Names of Substances
- Proton Pump Inhibitors * MeSH
BACKGROUND: This study aims to review the existing knowledge on the cost-effectiveness and item costs related to the diagnosis and treatment of gastroesophageal reflux disease (GERD) patients at different stages. METHODS: The study adhered to the PRISMA guidelines. The systematic search involved several steps: finding and identifying relevant articles, filtering them according to the set criteria, and examining the final number of selected articles to obtain the primary information. The number of articles published between 2013 and September 2024 in the Web of Science and PubMed databases was considered. The CHEERS checklist was used for the risk of bias assessment. Ultimately, 36 studies were included. RESULTS: Regarding the cost-effectiveness of GERD treatment, Proton pump inhibitors (PPIs) appeared to be the dominant solution for non-refractory patients. However, this might change with the adoption of the novel drug vonoprazan, which is more effective and cheaper. With advancements in emerging technologies, new diagnostic and screening approaches such as Endosheath, Cytosponge, and combined multichannel intraluminal impedance and pH monitoring catheters should be considered, with potential implications for optimal GERD management strategies. DISCUSSION: The new diagnostic methods are reliable, safe, and more comfortable than standard procedures. PPIs are commonly used as the first line of treatment for GERD. Surgery, such as magnetic sphincter augmentation or laparoscopic fundoplication, is only recommended for patients with treatment-resistant GERD or severe symptoms. OTHER: Advances in emerging technologies for diagnostics and screening may lead to a shift in the entire GERD treatment model, offering less invasive options and potentially improving patients' quality of life.
Betthera s r o Hradec Kralove Czech Republic
Faculty of Informatics and Management University of Hradec Kralove Hradec Kralove Czech Republic
See more in PubMed
Arnold M, Abnet CC, Neale RE, et al. Global burden of 5 major types of gastrointestinal Cancer. Gastroenterology. 2020;159(1):335–e34915. 10.1053/j.gastro.2020.02.068. PubMed PMC
United European Gastroenterology. Burden, economic impact and research gaps: Key findings from the Pan-European study on digestive diseases and cancers. 2024. https://www.nxtbook.com/ueg/UEG/burden-economic-impact-and-research-gaps/index.php#/p/1. Accessed 8 Oct 2024.
Wang R, Li Z, Liu S, Zhang D. Global, regional, and national burden of 10 digestive diseases in 204 countries and territories from 1990 to 2019. Front Public Health. 2023;11:1061453. 10.3389/fpubh.2023.1061453. PubMed PMC
Nirwan JS, Hasan SS, Babar ZUD, Conway BR, Ghori MU. Global prevalence and risk factors of Gastro-oesophageal reflux Disease (GORD): systematic review with Meta-analysis. Sci Rep. 2020;10(1):5814. 10.1038/s41598-020-62795-1. PubMed PMC
Gawron AJ, French DD, Pandolfino JE, Howden CW. Economic evaluations of gastroesophageal reflux Disease Medical Management. PharmacoEconomics. 2014;32(8):745–58. 10.1007/s40273-014-0164-8. PubMed PMC
Zhang D, Liu S, Li Z, Wang R. Global, regional and national burden of gastroesophageal reflux disease, 1990–2019: update from the GBD 2019 study. Ann Med. 2022;54(1):1372–84. 10.1080/07853890.2022.2074535. PubMed PMC
El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63(6):871–80. 10.1136/gutjnl-2012-304269. PubMed PMC
Schwenkglenks M, Marbet UA, Szucs TD. Epidemiology and costs of gastroesophageal reflux disease in Switzerland: a population-based study. Sozial- und Praventivmedizin/Social Prev Medicine. 2004;49(1):51–61. 10.1007/s00038-003-2090-y. PubMed
Willich SN, Nocon M, Kulig M, et al. Cost-of-disease analysis in patients with gastro-oesophageal reflux disease and Barrett’s mucosa. Aliment Pharmacol Ther. 2006;23(3):371–6. 10.1111/j.1365-2036.2006.02763.x. PubMed
Kamangar F, Nasrollahzadeh D, Safiri S, et al. The global, regional, and national burden of oesophageal cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the global burden of Disease Study 2017. The Lancet Gastroenterology Hepatology. 2020;5(6):582–97. 10.1016/S2468-1253(20)30007-8. PubMed PMC
Foroutan M, Zojaji H, Ehsani MJ, Darvishi M. Advances in the diagnosis of GERD using the esophageal pH monitoring, gastro-esophageal Impedance-pH monitoring, and Pitfalls. Open Access Maced J Med Sci. 2018;6(10):1934–40. 10.3889/oamjms.2018.410. PubMed PMC
Kuipers EJ. Barrett esophagus and life expectancy: implications for screening? Gastroenterol Hepatol (N Y). 2011;7(10):689–91. PubMed PMC
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred reporting items for systematic reviews and Meta-analyses: the PRISMA Statement. PLoS Med. 2009;6(7):e1000097. 10.1371/journal.pmed.1000097. PubMed PMC
Leung XY, Sun J, Bai B. Bibliometrics of social media research: a co-citation and co-word analysis. Int J Hospitality Manage. 2017;66:35–45. 10.1016/j.ijhm.2017.06.012.
Bank of England. Inflation calculator. 2024. https://www.bankofengland.co.uk/monetary-policy/inflation/inflation-calculator. Accessed 8 Oct 2024.
Inflation calculator. 2024. https://tools.csb.gov.lv/cpi_calculator/en/. Accessed 8 Oct 2024.
OECD Data Explorer • OECD Data Archive. OECD. 2024. https://data-explorer.oecd.org/vis?lc=en&df[ds]=DisseminateArchiveDMZ&df[id]=DF_DP_LIVE&df[ag]=OECD&av=true&pd=2022%2C2022&dq=EU27_2020%2BITA%2BAUS%2BAUT%2BBEL%2BCAN%2BCHL%2BCOL%2BCRI%2BCZE%2BDNK%2BEST%2BFIN%2BFRA%2BDEU%2BGRC%2BHUN%2BISL%2BIRL%2BISR%2BJPN%2BKOR%2BLVA%2BLTU%2BLUX%2BMEX%2BNLD%2BNZL%2BNOR%2BPOL%2BPRT%2BSVK%2BSVN%2BESP%2BSWE%2BCHE%2BTUR%2BGBR%2BUSA%2BOAVG%2BOECD.PPP...A&to[TIME_PERIOD]=false&vw=tb&lb=bt. Accessed 8 Oct 2024.
Lata T, Trautman J, Townend P, Wilson RB. Current management of gastro-oesophageal reflux disease—treatment costs, safety profile, and effectiveness: a narrative review. Gastroenterol Rep. 2022;11:goad008. 10.1093/gastro/goad008. PubMed PMC
Mathews SC, Izmailyan S, Brito FA, Yamal JM, Mikhail O, Revere FL. Prevalence and Financial Burden of Digestive Diseases in a commercially insured Population. Clin Gastroenterol Hepatol. 2022;20(7):1480–e14877. 10.1016/j.cgh.2021.06.047. PubMed
Katz PO, Dunbar KB, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ. ACG Clinical Guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022;117(1):27–56. 10.14309/ajg.0000000000001538. PubMed PMC
Miwa H, Takeshima T, Iwasaki K, Hiroi S. Medical cost, incidence rate, and treatment status of gastroesophageal reflux disease in Japan: analysis of claims data. J Med Econ. 2016;19(11):1049–55. 10.1080/13696998.2016.1192551. PubMed
Howden CW, Manuel M, Taylor D, Jariwala-Parikh K, Tkacz J. Estimate of Refractory Reflux Disease in the United States: Economic Burden and Associated Clinical characteristics. J Clin Gastroenterol. 2021;55(10):842–50. 10.1097/MCG.0000000000001518. PubMed
Bruley des Varannes S, Ducrotté P, Vallot T, et al. Gastroesophageal reflux disease: impact on work productivity and daily-life activities of daytime workers. A French cross-sectional study. Dig Liver Disease. 2013;45(3):200–6. 10.1016/j.dld.2012.11.005. PubMed
McCarty TR, Jirapinyo P, James LP, Gupta S, Chan WW, Thompson CC. Transoral incisionless fundoplication is cost-effective for treatment of gastroesophageal reflux disease. Endosc Int Open. 2022;10(07):E923–32. 10.1055/a-1783-9378. PubMed PMC
Lai L, Alvarez G, Aleu A, Apping C. Cost Avoidance Analysis of Medication Conversions on the Treatment of Gastroesophageal Reflux Disease in a medication Therapy Management Call Center: a budgetary perspective. J Pharm Pract. 2022;35(3):377–82. 10.1177/0897190020977764. PubMed
Park S, Park S, Park JM, et al. Anti-reflux surgery Versus Proton Pump inhibitors for severe gastroesophageal reflux disease: a cost-effectiveness study in Korea. J Neurogastroenterol Motil. 2020;26(2):215–23. 10.5056/jnm19188. PubMed PMC
Sharaiha RZ, Freedberg DE, Abrams JA, Wang YC. Cost-effectiveness of Chemoprevention with Proton Pump inhibitors in Barrett’s Esophagus. Dig Dis Sci. 2014;59(6):1222–30. 10.1007/s10620-014-3186-3. PubMed PMC
Habu Y. Vonoprazan versus Lansoprazole for the Initial Treatment of Reflux Esophagitis: a cost-effectiveness analysis in Japan. Intern Med. 2019;58(17):2427–33. 10.2169/internalmedicine.2535-18. PubMed PMC
Yokoya Y, Igarashi A, Uda A, Deguchi H, Takeuchi T, Higuchi K. Cost-utility analysis of a ‘vonoprazan-first’ strategy versus ‘esomeprazole- or rabeprazole-first’ strategy in GERD. J Gastroenterol. 2019;54(12):1083–95. 10.1007/s00535-019-01609-2. PubMed
Gronnier C, Desbeaux A, Piessen G, et al. Day-case versus inpatient laparoscopic fundoplication: outcomes, quality of life and cost-analysis. Surg Endosc. 2014;28(7):2159–66. 10.1007/s00464-014-3448-3. PubMed
Kleppe KL, Xu Y, Funk LM, et al. Healthcare spending and utilization following antireflux surgery: examining costs and reasons for readmission. Surg Endosc. 2020;34(1):240–8. 10.1007/s00464-019-06758-2. PubMed
Schlottmann F, Strassle PD, Patti MG. Comparative Analysis of Perioperative Outcomes and costs between laparoscopic and open antireflux surgery. J Am Coll Surg. 2017;224(3):327–33. 10.1016/j.jamcollsurg.2016.12.010. PubMed
Owen B, Simorov A, Siref A, Shostrom V, Oleynikov D. How does robotic anti-reflux surgery compare with traditional open and laparoscopic techniques: a cost and outcomes analysis. Surg Endosc. 2014;28(5):1686–90. 10.1007/s00464-013-3372-y. PubMed
Harper S, Grodzicki L, Mealing S, Gemmill L, Goldsmith PJ, Ahmed AR. Cost-effectiveness of a novel, non-active implantable device as a treatment for refractory gastro-esophageal reflux disease. J Med Econ. 2023;26(1):603–13. 10.1080/13696998.2023.2201063. PubMed
Harper S, Kartha M, Mealing S, Borbély YM, Zehetner J. Cost-effectiveness of the RefluxStop device for management of refractory gastroesophageal reflux disease in Switzerland. J Med Econ. 2024;27(1):805–15. 10.1080/13696998.2024.2362564. PubMed
Harper S, Grodzicki L, Mealing S, Gemmill E, Goldsmith P, Ahmed A. Budget Impact of RefluxStop™ as a treatment for patients with refractory gastro-oesophageal Reflux Disease in the United Kingdom. J Health Econ Outcomes Res. 2024;11(1). 10.36469/001c.90924. PubMed PMC
Ayazi S, Zaidi AH, Zheng P, et al. Comparison of surgical payer costs and implication on the healthcare expenses between laparoscopic magnetic sphincter augmentation (MSA) and laparoscopic Nissen fundoplication (LNF) in a large healthcare system. Surg Endosc. 2020;34(5):2279–86. 10.1007/s00464-019-07021-4. PubMed PMC
Pandolfino J, Lipham J, Chawla A, Ferko N, Hogan A, Qadeer RA. A budget impact analysis of a magnetic sphincter augmentation device for the treatment of medication-refractory mechanical gastroesophageal reflux disease: a United States payer perspective. Surg Endosc. 2020;34(4):1561–72. 10.1007/s00464-019-06916-6. PubMed
Park S, Kwon JW, Park JM, Park S, Hwang J, Seo KW. The characteristics of antireflux surgery compared to Proton pump inhibitor treatment in Korea: a nationwide study using claim data from 2007 to 2016. Ann Surg Treat Res. 2020;98(5):254. 10.4174/astr.2020.98.5.254. PubMed PMC
Funk LM, Zhang JY, Drosdeck JM, Melvin WS, Walker JP, Perry KA. Long-term cost-effectiveness of medical, endoscopic and surgical management of gastroesophageal reflux disease. Surgery. 2015;157(1):126–36. 10.1016/j.surg.2014.05.027. PubMed
Kleiman DA, Beninato T, Bosworth BP, et al. Early Referral for esophageal pH monitoring is more cost-effective than prolonged empiric trials of Proton-Pump inhibitors for suspected gastroesophageal reflux disease. J Gastrointest Surg. 2014;18(1):26–34. 10.1007/s11605-013-2327-x. PubMed
Azzam RS, Azzam GB, Nasi A, WIRELESS PH MONITORING AND CONVENTIONAL ESOPHAGEAL PH, MONITORING: COMPARATIVE STUDY OF DISCOMFORT, LIMITATIONS IN DAILY ACTIVITIES AND COMPLICATIONS. ABCD arq bras cir dig. 2021;34(1):e1566. 10.1590/0102-672020210001e1566. PubMed PMC
Afaneh C, Zoghbi V, Finnerty BM, et al. BRAVO esophageal pH monitoring: more cost-effective than empiric medical therapy for suspected gastroesophageal reflux. Surg Endosc. 2016;30(8):3454–60. 10.1007/s00464-015-4629-4. PubMed
Lawenko RMA, Lee YY. Evaluation of gastroesophageal reflux Disease using the Bravo Capsule pH system. J Neurogastroenterol Motil. 2015;22(1):25–30. 10.5056/jnm15151. PubMed PMC
Törer N, Aytaç Ö. Is the routine use of Impedance Analysis for the diagnosis of Gastro-Esophageal Reflux Disease more expensive than conventional pH monitoring? Cost analysis of two procedures. Indian J Surg. 2017;79(3):192–5. 10.1007/s12262-016-1444-7. PubMed PMC
Moriarty JP, Shah ND, Rubenstein JH, et al. Costs associated with Barrett’s esophagus screening in the community: an economic analysis of a prospective randomized controlled trial of sedated versus hospital unsedated versus mobile community unsedated endoscopy. Gastrointest Endosc. 2018;87(1):88–e942. 10.1016/j.gie.2017.04.019. PubMed PMC
Honing J, Kievit W, Bookelaar J, Peters Y, Iyer PG, Siersema PD. Endosheath ultrathin transnasal endoscopy is a cost-effective method for screening for Barrett’s esophagus in patients with GERD symptoms. Gastrointest Endosc. 2019;89(4):712–e7223. 10.1016/j.gie.2018.10.024. PubMed
Furneri G, Klausnitzer R, Haycock L, Ihara Z. Economic value of narrow-band imaging versus white light endoscopy for the diagnosis and surveillance of Barrett’s esophagus: Cost-consequence model. Geisler BP, ed. PLoS ONE. 2019;14(3):e0212916. 10.1371/journal.pone.0212916. PubMed PMC
Singer ME, Smith MS. Wide area transepithelial sampling with computer-assisted analysis (WATS3D) is cost-effective in Barrett’s Esophagus Screening. Dig Dis Sci. 2021;66(5):1572–9. 10.1007/s10620-020-06412-1. PubMed PMC
Benaglia T, Sharples LD, Fitzgerald RC, Lyratzopoulos G. Health benefits and cost effectiveness of endoscopic and nonendoscopic cytosponge screening for Barrett’s Esophagus. Gastroenterology. 2013;144(1):62–e736. 10.1053/j.gastro.2012.09.060. PubMed
Sami SS, Moriarty JP, Rosedahl JK, et al. Comparative cost effectiveness of reflux-based and reflux-independent strategies for Barrett’s Esophagus Screening. Am J Gastroenterol. 2021;116(8):1620–31. 10.14309/ajg.0000000000001336. PubMed PMC
Swart N, Maroni R, Muldrew B, Sasieni P, Fitzgerald RC, Morris S. Economic evaluation of Cytosponge®-trefoil factor 3 for Barrett esophagus: a cost-utility analysis of randomised controlled trial data. eClinicalMedicine. 2021;37:100969. 10.1016/j.eclinm.2021.100969. PubMed PMC
Habu Y, Hamasaki R, Maruo M, Nakagawa T, Aono Y, Hachimine D. Treatment strategies for reflux esophagitis including a potassium-competitive acid blocker: a cost‐effectiveness analysis in Japan. J Gen Fam Med. 2021;22(5):237–45. 10.1002/jgf2.429. PubMed PMC
Park S, Kwon JW, Park JM, Park S, Seo KW. Treatment pattern and economic Burden of Refractory Gastroesophageal Reflux Disease patients in Korea. J Neurogastroenterol Motil. 2020;26(2):281–8. 10.5056/jnm19050. PubMed PMC
Jamshed S, Bhagavathula AS, Zeeshan Qadar SM, Alauddin U, Shamim S, Hasan S. Cost-effective analysis of Proton Pump inhibitors in long-term management of gastroesophageal reflux disease: a narrative review. Hosp Pharm. 2020;55(5):292–305. 10.1177/0018578719893378. PubMed PMC
Gockel I, Lange UG, Schürmann O, et al. Kosten-Effektivitäts- Und Kosten-Nutzwert-Analysen Der Antirefluxmedizin. Gesundheitswesen. 2019;81(12):1048–56. 10.1055/a-0586-3630. PubMed
Yang L, Chaudhary N, Baghdadi J, Pei Z. Microbiome in Reflux Disorders and esophageal adenocarcinoma. Cancer J. 2014;20(3):207–10. 10.1097/PPO.0000000000000044. PubMed PMC
Karjoo M, Beg M, Kesselring S, Reliability. Safety and Effectiveness of the Bravo(TM) Capsule: a catheter-free pH monitoring system for evaluation of Gastroesophageal Reflux Disease in children. Middle East J Dig Dis. 2012;4(1):34–9. PubMed PMC
Rubenstein JH, Inadomi JM, Brill JV, Eisen GM. Cost utility of screening for Barrett’s Esophagus with Esophageal Capsule Endoscopy Versus Conventional Upper Endoscopy. Clin Gastroenterol Hepatol. 2007;5(3):312–8. 10.1016/j.cgh.2006.12.008. PubMed