A NEW APPROACH TO USING SELF-REPORTED UTILIZATION TO ESTIMATE COST ASSOCIATED WITH MILD, MODERATE, AND SEVERE GERD-RELATED SYMPTOMS
Author(s)
Quan V Doan, PharmD, MSHS, Senior Associate Director1, Daniel Aguilar, MPH, Research Associate1, Adam B Elfant, MD, Assitant Professor of Medicine2, Stephen M Lange, MD, Chair, Gastroenterology3, Eileen Reyes, BS, Research Associate1, Bonnie B Dean, PhD, Research Project Leader1, Richard B Lynn, MD, Sr Director, Global Medical Affairs4, Robert W Dubois, MD, PhD, Senior Vice President11Cerner Health Insights, Beverly Hills, CA, USA; 2 Cooper Hospital/University Medical Center, Camden, NJ, USA; 3 Mayo Clinic Jacksonville, Jacksonville, FL, USA; 4 Wyeth Pharmaceuticals, Collegeville, PA, USA
OBJECTIVES: Previous literature reported patients with GERD have $240 more in medical care costs compared with patients without GERD (JMCM 2003;7:6-13). However, no data exist to differentiate these costs by symptom severity. This study's purpose was to assess utilization and costs associated with mild, moderate, and severe GERD-related symptoms using a new approach. METHODS: An Internet-based survey of US adults was conducted using GERD Symptom & Medication Questionnaire (GERD-SMQ), a validated screening tool. Severity of heartburn and acid regurgitation symptoms were rated on a 10-point scale. The highest rating value of heartburn and acid regurgitation was used. Respondents were classified into the following severity strata: mild (1-4), moderate (5-7), and severe (8-10). Subjects were asked to report the frequency of hospitalizations, emergency room visits, physician office visits, tests, and procedures relating to GERD over the past six months. Utilization of each component was converted into monetary value using publicly available fee schedules. Imputed costs for each severity stratum were summed and divided by the average total imputed cost among all cases to determine the utilization weights relative to the “average” GERD case. Utilization weights were multiplied by $240 to estimate cost for each severity stratum. RESULTS: A total of 701 GERD cases were identified: 22.1%, 48.6%, and 24.0% were categorized as mild, moderate, and severe and the remaining 5.3% as having no active symptoms. Compared with “average” GERD cases, patients classified as having mild, moderate, and severe GERD-related symptoms had relative utilization weights of 0.404, 0.610, and 2.458 respectively, and GERD-attributable costs of $97, $146, and $590 per year respectively. CONCLUSIONS: Self-reported utilization can be used to differentiate costs across severity strata in GERD sufferers. This information is useful for modeling the economic consequences of reducing GERD-related severity and may be applicable to other conditions when published data are incomplete.
Conference/Value in Health Info
2006-05, ISPOR 2006, Philadelphia, PA
Value in Health, Vol. 9, No.3 (May/June 2006)
Code
PGI18
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Gastrointestinal Disorders