High Economic Burden of Caring for Patients With Suspected Extraesophageal Reflux

Abstract

EER contributes substantially to health-care expenditures. In this cohort, the cost for initial year's evaluation and treatment of EER symptoms was quintuple that of typical GERD. Prescription costs and, in particular, proton pump inhibitors were the single greatest contributor to the cost of EER management.

Long-term results of electrical stimulation of the lower esophageal sphincter for treatment of proximal GERD

“…Therefore, patients with laryngeal symptoms require multiple specialty consultations, diagnostic/therapeutic procedures and medications, resulting in 5.6 times higher direct cost than that for typical GERD [31]. A 3-month empiric trial of high-dose proton pump inhibitors (PPI) has been recommended as an initial diagnostic measure [32]; however, PPIs have a significant placebo effect and a recent meta-analysis has demonstrated no therapeutic benefit of PPIs in this setting [2,3].…”

Feasibility Trial of the Newly Introduced Optical Enhancement Technology in Patients with Gastroesophageal Reflux Disease

“…GERD is associated with a large social-economic burden [15]. Furthermore, Barrett's esophagus is a serious complication of GERD since it is considered a precursor for esophageal adenocarcinoma.…”

Definitions of Gastroesophageal Reflux Disease (GERD)

“…Although the overall sensitivity for detection of esophagitis (seen as a reticular or finely nodular pattern) may be around 65 %, the sensitivity decreases for milder grades of esophagitis [20]. Barium radiology without any provocative maneuvers detects one third to one half of patients with GERD [75,76]; evidence of reflux can be seen with provocative maneuvers in as many as 70 % [77].…”

“…The accuracy of available diagnostic tests, including laryngoscopy, upper endoscopy, pH-metry, and pH-impedance testing, for the evaluation of suspected extra-esophageal reflux symptoms is suboptimal [19], and contributes substantially to health-care expenditures. In fact, the initial year's cost for the workup and management of suspected extra-esophageal reflux symptoms may be more than five times than that for typical GERD [20].…”