[Cost-Effectiveness and Cost-Utility Analyses of Antireflux Medicine]. / Kosten-Effektivitäts- und Kosten-Nutzwert-Analysen der Antirefluxmedizin.
Gesundheitswesen
; 81(12): 1048-1056, 2019 Dec.
Article
en De
| MEDLINE
| ID: mdl-29649837
ABSTRACT
INTRODUCTION:
Laparoscopic antireflux surgery and medical therapy with proton pump inhibitors are gold standards of gastroesophageal reflux treatment. On account of limited resources and increasing healthcare needs and costs, in this analysis, not only optimal medical results, but also superiority in health economics of these 2 methods are evaluated.METHODS:
We performed an electronic literature survey in MEDLINE, PubMed, Cochrane Library, ISRCTN (International Standard Randomization Controlled Trial Number) as well as in the NHS Economic Evaluation Database, including studies published until 1/2017. Only studies considering the effect size of QALY (Quality-Adjusted Life Years) (with respect to different quality of life-scores) as primary outcome comparing laparoscopic fundoplication and medical therapy were included. Criteria of comparison were ICER (Incremental Cost-Effectiveness Ratio) and ICUR (Incremental Cost-Utility Ratio). Superiority of the respective treatment option for each publication was worked out.RESULTS:
In total, 18 comparative studies were identified in the current literature with respect to above-mentioned search terms, qualifying for the defined inclusion criteria. Six studies were finally selected for analyses. Out of 6 publications, 3 showed superiority of laparoscopic fundoplication over long-term medical management based on current cost-effectiveness data. Limitations were related to different time intervals, levels of evidence of studies and underlying resources/costs of analyses, healthcare systems and applied quality of life instruments.CONCLUSION:
Future prospective, randomized trials should examine this comparison in greater detail. Additionally, there is a large potential for further research in the health economics assessment of early diagnosis and prevention measures of reflux disease and Barrett's esophagus/carcinoma.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_financiamento_saude
Asunto principal:
Calidad de Vida
/
Reflujo Gastroesofágico
/
Costos de la Atención en Salud
Tipo de estudio:
Clinical_trials
/
Guideline
/
Health_economic_evaluation
/
Prognostic_studies
/
Screening_studies
/
Systematic_reviews
Aspecto:
Patient_preference
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
De
Revista:
Gesundheitswesen
Asunto de la revista:
SAUDE PUBLICA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Alemania