Costs for Surgical Treatment of GERD Not Offset by Savings on Medications

A recent study presented at the 67th Annual Scientific Meeting of the American College of Gastroenterology shows that although people with GERD (gastroesophageal reflux disease) experienced a 62 percent decline in the average number of days of acid reduction therapy after surgery, one-half of patients received at least one prescription for acid reduction therapy during the 18 months following surgery. More than 15 million Americans experience daily heartburn symptoms and may suffer from GERD.

"To assess the economic implications of medical versus surgical management of GERD, we analyzed medical costs for patients one year before and 18 months after surgery," said the study's lead author Erin M. Sullivan, Ph.D., of the Boston Scientific Corporation (Natick, MA). "The assumption has been that the one-time cost of surgery is lower than the long-term cost of drugs, but we found that the surgery costs were not offset by the reduction in medication costs during an 18-month follow-up period," said Dr. Sullivan.

The symptoms of GERD are caused when the valve between the stomach andesophagus allows stomach acid to leak into the esophagus. Some people with GERD opt for surgery when drugs do not help enough or when they want to avoid taking drugs for the rest of their lives. When surgery is successful, the one-way valve between the esophagus and stomach works and GERD symptoms reportedly improve.

The researchers examined data from a national database of publicly and privately insured patients. The records of 123 surgical patients were matched to the records of 246 GERD patients managed without surgery. Patients were matched according to age, sex, and other factors.

Slightly more than one-half (54 percent) of patients were female, and the average age of the subjects was 48 years. To control for inflation, Sullivan and colleagues converted all medical costs to 2001 U.S. dollars.

ãDuring the 18 months following surgery, average medication costs were lower in surgically managed patients compared to medically managed patients. However, due to the surgery costs, overall medical costs were higher among surgically managed patients,ä said Dr. Sullivan. ãOur results indicate that we need to follow GERD patients over a longer follow-up period to determine the actual cost-effectiveness of surgery."

The ACG was formed in 1932 to advance the scientific study and medical treatment of disorders of the gastrointestinal (GI) tract. The College promotes the highest standards in medical education and is guided by its commitment to meeting the needs of clinical gastroenterology practitioners. Consumers can get more information on GI diseases through the following ACG-sponsored programs:

á 1-800-978-7666 (free brochures on common GI disorders, including ulcer, colon cancer, gallstones, and liver disease)á 1-800-HRT-BURN (free brochure and video on heartburn and GERD)á http://www.acg.gi.org (ACGâs Web site)