OBJECTIVES : Laparoscopic fundoplication (LF) is a standard surgical treatment for Gastroesophageal Reflux Disease (GERD). Direct medical costs and utilization rate (UR) of LP in the US have not been well studied. The objective of this study is to evaluate direct medical cost and UR of LF in US adult patients with GERD.

METHODS : A retrospective analysis was performed using the Truven Health MarketScan® Research Database 2013 to 2015 (study period). The study population included patients diagnosed with GERD (based on ICD-9/10-CM codes) who received LF (CPT code= 43280) as inpatients or outpatients. Pediatric patients and patients with a history of lung/pleura transplant or cancer were excluded. Only patients with continuous insurance enrollment of at least 3 months from the date of first LF were included. Each LF with a distinct service date was considered an episode. Costs were evaluated as ‘same day’ (SD) and ‘total-direct’ (TD) per episode. SD costs included all expenses incurred on the day of the LF at an episode level. TD costs included same-day costs, costs for GERD-related procedures and any LF‑related complications that occurred within 3 months after LF at a patient level. The UR of LF was calculated as the number of LF episodes divided by the total number of GERD patient-years throughout study period.

RESULTS : CONCLUSIONS : Among US GERD patients, the utilization rate of laparoscopic fundoplication was low, but associated costs were substantial.