Anti-reflux Surgery Versus Proton Pump Inhibitors for Severe Gastroesophageal Reflux Disease: A Cost-Effectiveness Study in Korea
- Author:
Susan PARK
1
;
Sungsoo PARK
;
Joong-Min PARK
;
Soorack RYU
;
Jinseub HWANG
;
Jin-Won KWON
;
Kyung Won SEO
Author Information
- Publication Type:Original Article
- From:Journal of Neurogastroenterology and Motility 2020;26(2):215-223
- CountryRepublic of Korea
- Language:0
-
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.
