SURGERY OR DRUGS: WHAT IS THE BEST WAY TO MANAGE PATIENTS WITH GASTRO-ESOPHAGEAL REFLUX DISEASE (GERD)?

Hamilton, Ontario, Canada – Physician’s, patients and health care decision makers need an answer to the long standing question of whether surgery or medication is better in the long run for treating chronic diseases like GERD

To determine if the ‘up front’ higher cost of surgery compared to regular treatment with medications is worth it in terms of long term costs, outcomes and patient quality of life (QOL).

Over the 3 year follow-up of patients randomized to surgery or medical management, symptom scores were similar between groups but QOL was slightly improved for surgical patients. Costs were also higher for surgery patients, but cumulative costs are projected to be lower for surgery treated patients compared to drug managed patients by about year 4 or 5. Overall, surgery represents good value for money, and the relative cost-effectiveness of surgery increases over time.

GERD is a common disorder affecting up to 30% of the population. Few controlled trials have addressed the long term outcomes of surgery versus medical management and the trials that do exist provide conflicting results. Long term modeling studies assessing cost-effectiveness of surgery have had to make strong assumptions, many of which are not based on ‘real world’ observed patient follow-up data. As a result, long term clinical and economic evaluation studies based on actual patient measurement and follow-up are needed.

Lead author Professor Goeree noted "The results of this study will change how we manage patients with long-term GERD. This study will result in lower costs to patients, healthcare plans and at the same time improve quality of life for patients". Ron Goeree, MA, Associate Professor, McMaster University, Director, Programs for Assessment of Technology in Health, St. Joseph's Healthcare Hamilton.

This will be discussed in a future issue of Value in Health, the official journal of the International Society for Pharmacoeconomics and outcomes Research.

Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research and help health care leaders to make decisions that are solidly evidence-based.  The journal is published bi-monthly and has a regular readership of over 5,000 clinicians, decision-makers, and researchers worldwide.

ISPOR is a nonprofit, international organization that strives to translate pharmacoeconomics and outcomes research into practice to ensure that society allocates scarce health care resources wisely, fairly, and efficiently.

For more information: www.ispor.org

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