A cost-effectiveness analysis of RefluxStop against relevant therapeutic alternatives for chronic gastroesophageal reflux disease in Sweden.

IF 1.8 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2024-10-20 DOI:10.1080/14737167.2024.2417774

Sam Harper, Muralikrishnan Kartha, Stuart Mealing, Lars Lundell

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Abstract

Introduction: The standard treatment for gastroesophageal reflux disease (GERD) is proton pump inhibitors (PPIs). In selected cases, Nissen fundoplication is offered as a surgical treatment option, but alternative endoscopic and minimally invasive surgical alternatives are emerging. RefluxStop is a new technology for the treatment of GERD.

Research design and methods: A cost-effectiveness analysis of RefluxStop in comparison to PPI therapy and Nissen fundoplication in the Swedish healthcare setting was conducted using a Markov model and available comprehensive population and clinical trial-based long-term data. Benefits were measured in quality-adjusted life-years (QALYs). Uncertainty was determined by deterministic and probabilistic sensitivity analyses.

Results: The base case incremental cost-effectiveness ratios (ICERs) for RefluxStop in comparison to PPIs and Nissen fundoplications were SEK 48,152 (€ 4,531) and SEK 62,966 (€ 5,925) per QALY gained, respectively. At a cost-effectiveness threshold of SEK 500,000 per QALY gained, RefluxStop has a high likelihood of being cost-effective, with probabilities of 96% and 100% against Nissen fundoplication and PPIs, respectively. The results of the model remained robust with sensitivity analysis.

Conclusions: RefluxStop may offer a highly cost-effective long-term treatment alternative for chronic GERD patients over lifelong PPI therapy, but also in comparison with laparoscopic Nissen fundoplication.

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瑞典针对慢性胃食管反流病的 RefluxStop 与相关替代疗法的成本效益分析。

简介：胃食管反流病（GERD）的标准治疗方法是质子泵抑制剂（PPIs）。在特定病例中，可选择尼森胃底折叠术（Nissen fundoplication）作为手术治疗方案，但替代性内窥镜和微创手术方案正在出现。RefluxStop 是一种治疗胃食管反流病的新技术：研究设计和方法：利用马尔可夫模型和现有的基于人口和临床试验的长期综合数据，对 RefluxStop 与 PPI 治疗和 Nissen 胃底折叠术进行了成本效益分析。疗效以质量调整生命年（QALYs）来衡量。通过确定性和概率敏感性分析确定了不确定性：与 PPIs 和 Nissen fundoplications 相比，RefluxStop 的基本病例增量成本效益比（ICER）分别为每 QALY 48,152 瑞典克朗（4,531 欧元）和 62,966 瑞典克朗（5,925 欧元）。在每QALY收益500,000瑞典克朗的成本效益阈值下，RefluxStop极有可能具有成本效益，与Nissen胃底折叠术和PPIs相比，其成本效益概率分别为96%和100%。该模型的结果在进行敏感性分析后仍然保持稳健：RefluxStop 可为慢性胃食管反流病患者提供极具成本效益的长期治疗方案，不仅优于终身 PPI 治疗，而且与腹腔镜尼森胃底折叠术相比也更具成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Pharmacoeconomics & Outcomes Research HEALTH CARE SCIENCES & SERVICES-PHARMACOLOGY & PHARMACY

CiteScore

4.00

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Expert Review of Pharmacoeconomics & Outcomes Research (ISSN 1473-7167) provides expert reviews on cost-benefit and pharmacoeconomic issues relating to the clinical use of drugs and therapeutic approaches. Coverage includes pharmacoeconomics and quality-of-life research, therapeutic outcomes, evidence-based medicine and cost-benefit research. All articles are subject to rigorous peer-review. The journal adopts the unique Expert Review article format, offering a complete overview of current thinking in a key technology area, research or clinical practice, augmented by the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.