Objectives: Gastroesophageal reflux disease (GERD) is a risk factor for Barrett’s esophagus (BE) and esophageal neoplasia (EN). The objective was to evaluate healthcare resource utilization (HRU) and costs associated with GERD, BE, and EN in the US.

Methods: Using diagnosis codes in medical claims, adult patients with GERD, non-dysplastic BE (NDBE), and EN, including indefinite for dysplasia (IND), low-grade dysplasia (LGD), high-grade dysplasia (HGD), or esophageal adenocarcinoma (EAC), were identified from the IBM Truven Health MarketScan databases (Q1/2015-Q4/2019) and categorized into the corresponding mutually exclusive cohorts based on the most advanced stage from GERD to EAC. Disease-related HRU and costs (2020 USD) were described for each cohort.

Results: A total of 3,310,385 patients were categorized into the GERD, 172,481 into NDBE, 11,516 into IND, 4,332 into LGD, 1,549 into HGD, and 11,676 into the EAC cohort. By cohort, mean age (year) and proportion of female were: 51.02 and 59.58% (GERD), 57.05 and 43.90% (NDBE), 58.07 and 41.21% (IND), 60.12 and 33.10% (LGD), 61.29 and 23.18% (HGD), and 62.79 and 25.15% (EAC). Disease-related annual mean number inpatient admissions, office visits, and emergency room visits by cohort were: 0.09, 1.45, and 0.19 for GERD; 0.08, 1.55, and 0.10 for NDBE; 0.10, 1.92, and 0.13 for IND; 0.09, 2.05, and 0.10 for LGD; 0.12, 2.16, and 0.14 for HGD; and 1.43, 6.27, and 0.87 for EAC. Disease-related annual mean total healthcare costs by cohort were: $6,955 for GERD, $8,755 for NDBE, $9,675 for IND, $12,241 for LGD, $24,239 for HGD, and $146,319 for EAC.

Conclusions: Patients with GERD, BE, and EN had important HRU and costs, including inpatient admissions and office visits. As patients progressed from GERD to BE to EAC, there were substantially higher disease-related resource utilization and associated costs.