Cd Smith, Director, Esophageal Institute of Atlanta1, J Grudem, Chief Scientist2, Ng Martinson, President3. 1Esophageal Institute of Atlanta, 2Torax Medical Inc, 3Acclaim Analytics
INTRODUCTION: GERD has a spectrum of consequences affecting over 60 million Americans with over $10 billion in expense. Clinical sequellae range from quality-of-life altering symptoms, to chronic tissue damage leading Barrett’s esophagus. How to best manage GERD remains controversial depending on how the condition is defined and what is identified as an appropriate outcome (e.g, quality-of-life v. prevention of disease progression). Economic burden is one way to understand GERD and may provide a useful classification for decision making. Herein is an analysis of GERD direct medical costs fromclaims data rather than charges or costs.
METHODS: All medical claims matching a select group of 327 HCPCS and 33 Diagnosis Codes paid from 1/1/2001-12/31/2011 by a large commercial managed-care database covering 82 million lives was interrogated. Patients included met criteria: a) 6-years continuous claims, b) at least 3-years of PPI use during 6-year period, c) complete PPI pharmacy claims data. This yielded 165,546 unique patients for analysis. This cohort was further classified: A) single daily dose of PPI (SDPPI), B) stable daily double dose PPI (SDDPPI), C) Escalating double dose (EDDPI) without Barretts, D) EDDPPI with Barretts. Dollar amount of paid claims for the entire 6-year period was calculated for each group using a Conservative Definition (GERD as the primary or secondary diagnosis) and a Broader Definition (GERD-related disease as the primary diagnosis (e.g., laryngitis or asthma).
SUMMARY: Compared to patients on SDPPI, need for DDPI and/or the presence of Barretts esophagus leads to increased cost of GERD care.
CONCLUSION: Classifying GERD based on economic burden provides another way to characterize GERD. Understanding the relationship between more clinically advanced GERD and cost of care will help guide the most cost effective delivery of care for GERD.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80586
Program Number: P404
Presentation Session: Poster (Non CME)
Presentation Type: Poster