A budget impact analysis of a magnetic sphincter augmentation device for the treatment of medication-refractory mechanical gastroesophageal reflux disease: a United States payer perspective

Pandolfino, John E.; Lipham, John C.; Chawla, A.S.; Ferko, Nicole; Hogan, Andrew J.; Qadeer, Rana A.

doi:10.1007/s00464-019-06916-6

Cited by 8 publications

(4 citation statements)

References 45 publications

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“…An economic budget impact model for a hypothetical commercial insurance population of 1 million members over a 1-year time horizon estimated a net cost savings of $111,367 with introduction of MSA compared with medical management or laparoscopic Nissen fundoplication, primarily driven by the avoidance of hospital admission. 49 Further, a prospective observational study comparing MSA and laparoscopic Nissen fundoplication found that at 12 months after surgery, reimbursement for medical expenses decreased by 11% for MSA and 1% for laparoscopic Nissen fundoplication compared with preoperative reimbursement. 50 …”

Section: Outcomes Compared With Fundoplicationmentioning

confidence: 99%

The role of magnetic sphincter augmentation in the gastroesophageal reflux disease treatment pathway: the gastroenterology perspective

Patel

Gyawali

2023

Diseases of the Esophagus

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Magnetic sphincter augmentation (MSA) is a surgical intervention for well-characterized gastroesophageal reflux disease (GERD), where the esophagogastric junction barrier is augmented using a bracelet of magnetized titanium beads. MSA could be an attractive option for patients with documented GERD who wish to avoid long-term pharmacologic therapy or whose symptoms are not adequately managed with lifestyle modifications and pharmacologic therapy. The ‘ideal’ MSA patient is one with prominent regurgitation, without dysphagia or esophageal motor dysfunction, with objective evidence of GERD on upper endoscopy and/or ambulatory reflux monitoring. Appropriate candidates with significant hiatus hernia may pursue MSA with concomitant hiatus hernia repair. The increasing adoption of MSA in the GERD treatment pathway reflects research that shows benefits in long-term outcomes and healthcare costs compared with other established therapies in appropriate clinical settings.

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Section: Outcomes Compared With Fundoplicationmentioning

confidence: 99%

The role of magnetic sphincter augmentation in the gastroesophageal reflux disease treatment pathway: the gastroenterology perspective

Patel

Gyawali

2023

Diseases of the Esophagus

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“…It also used insurance reimbursement costs for PPIs rather than over-the-counter costs [ 89 ]. In another study, modelling predicted that introduction of MSA into current practice would potentially improve the budgetary impact of treating PPI-refractory GORD for commercial payers in the USA [ 90 ].…”

Section: Gord Treatment: Cost-effectivenessmentioning

confidence: 99%

Current management of gastro-oesophageal reflux disease—treatment costs, safety profile, and effectiveness: a narrative review

Lata

Trautman

Townend

et al. 2022

Gastroenterology Report

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Background The purpose of this study was to review the current management of gastro-oesophageal reflux disease (GORD), including treatment costs, safety profile and effectiveness. Methods A literature review was performed of randomized-controlled trials, systematic reviews, Cochrane reports and National/Societal guidelines of the medical, endoscopic and surgical management of GORD. Proton pump inhibitor (PPI) prescribing patterns and expenditure were reviewed in different countries, including Australia, Canada, New Zealand, UK and USA. Results Proton pump inhibitors (PPIs) are primarily indicated for control of GORD, Helicobacter pylori eradication (combined with antibiotics), preventing NSAID-induced gastrointestinal bleeding and treating peptic ulcer disease. There is widespread overprescribing of PPIs in Western and Eastern nations in terms of indication and duration, with substantial expense for national health providers. Despite a favourable short-term safety profile, there are observational associations of adverse effects with long-term PPIs. These include nutrient malabsorption, enteric infections and cardiovascular events. The prevalence of PPI use makes their long-term safety profile clinically relevant. Cost-benefit, symptom control and quality-of-life outcomes favour laparoscopic fundoplication rather than chronic PPI treatment. Laparoscopic fundoplication in long-term management of PPI-responsive GORD is supported by SAGES, NICE and ACG, and PPI-refractory GORD by AGA and SAGES guidelines. The importance of establishing a definitive diagnosis prior to invasive management is emphasized, especially in PPI-refractory heartburn. Conclusions We examined evidence-based guidelines for PPI prescribing and deprescribing in primary care and hospital settings and the need for PPI stewardship and education of health professionals. This narrative review presents the advantages and disadvantages of surgical, endoscopic and medical management of GORD, which may assist in shared decision making and treatment choice in individual patients. This paper was presented (GS020) at the 88th RACS Annual Scientific Conference, 6-10 May, 2019.

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“…13,14 With regards to hospital charges, MSA and fundoplication have been found to be very similar. 15,16…”

Section: Introductionmentioning

confidence: 99%

“…13,14 With regards to hospital charges, MSA and fundoplication have been found to be very similar. 15,16 While scientific data on the utility of MSA has grown over time, a few studies have examined its efficacy in severe GERD. 17,18 However, studies are lacking regarding its effectiveness compared to fundoplication in this particular context.…”

Section: Introductionmentioning

confidence: 99%

Comparing the Outcomes of MSA and Fundoplication in Severe GERD

Wang

Silva

James

et al. 2022

Foregut: The Journal of the American Foregut Society

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Introduction: Magnetic sphincter augmentation (MSA) is an effective treatment option for gastroesophageal reflux disease (GERD), with similar outcomes to fundoplication. MSA has yet to be compared to fundoplication specifically in patients with severe GERD. The objective of this study was to compare MSA and fundoplication in patients with severe GERD. Methods: A retrospective cohort study was performed of patients with severe GERD (preoperative DeMeester score >50) who underwent MSA or fundoplication at 3 high-volume centers from 2016 to 2019. Nissen and partial fundoplications were included. GERD control was measured by GERD health-related quality of life (GERD-HRQL) scores and discontinuation of acid suppressive medication (ASM). Other outcomes included postoperative gas-bloat symptoms, dysphagia requiring dilation, and esophagitis. Results: A total of 122 patients were included: 82 (67%) underwent MSA and 40 (33%) underwent fundoplication (23% Nissen, 77% partial). The groups were similar regarding gender, GERD duration, hiatal hernia size, preoperative GERD-HRQL score, severe esophagitis, and DeMeester score. Median follow-up was 24 [12-34] months. Postoperative GERD-HRQL scores (5 vs 3, P = .36), ASM discontinuation (80% vs 86%, P = .41), gas-bloat symptoms (18% vs 23%, P = .58), dysphagia requiring dilation (19% vs 8%, P = .11), and esophagitis (7% vs 10%, P = .08) were similar between the groups. A subset analysis was performed comparing outcomes of MSA, Nissen fundoplication, and partial fundoplication. No significant differences were found. Conclusion: In this cohort of patients with severe GERD, MSA was just as effective as Nissen and partial fundoplication with regards to improved quality of life and side effect profile at 24-month follow-up.

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A budget impact analysis of a magnetic sphincter augmentation device for the treatment of medication-refractory mechanical gastroesophageal reflux disease: a United States payer perspective

Cited by 8 publications

References 45 publications

The role of magnetic sphincter augmentation in the gastroesophageal reflux disease treatment pathway: the gastroenterology perspective

The role of magnetic sphincter augmentation in the gastroesophageal reflux disease treatment pathway: the gastroenterology perspective

Current management of gastro-oesophageal reflux disease—treatment costs, safety profile, and effectiveness: a narrative review

Comparing the Outcomes of MSA and Fundoplication in Severe GERD

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