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Comparison of efficacy, safety and cost-effectiveness of laparoscopic Nissen fundoplication and omeprazole pharmacotherapy in GERD treatment.

Plisko R, Slawik M, Landa K; Health Technology Assessment International. Meeting (2nd : 2005 : Rome, Italy).

Ital J Public Health. 2005;2:179.

HTA Consulting, Bozego Ciala 3/16, Krakow, Malopolska 31-055 Poland Tel: +48 604112138, Fax: 48124218832, E-mail: plisko@hta.pl

Objectives: Assessment of efficacy and safety of omeprazole (OME) vs laparoscopic Nissen fundoplication (LNF) in treatment of gastroesophageal reflux disease from payer's perspective. Methods: Comparisons were based on valid RCTs found in a systematic review. Current costs of medications and medical services in Poland on representative number of sources were collected. Due to absence of head to head trials indirect comparison based on open Nissen fundoplication (ONF) was exercised. Cost mimimalization analysis was performed according to the results of efficacy & safety analysis. Efficacy & safety results: We did not find significant differences between LNF and ONF in regards to efficacy & safety in GERD treatment. ONF results in better GERD symptom control in comparison with OME. OME has better safety profile than ONF. Indirect comparison was only possible in regards to few end points. There were no significant differences between LNF and OME. LNF is probably more efficacious than ONF. The assumptions of similar effectiveness between LNF and OME may result in underassessment of the results for LNF in cost-effectiveness analysis. OME has better safety profile than LNF. Cost effectiveness results: The use of LNF instead of OME (Losec) resulted in cost savings (886 EURO) in five-year perspective. Results of sensitivity analysis do not change the conclusions. Conclusions: Based on the efficacy & safety and cost-effectiveness analysis it may be concluded that LNF is a dominant option over OME in GERD treatment in a five-year perspective.

Publication Types:

  • Meeting Abstracts

Keywords:

  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Fundoplication
  • Gastroesophageal Reflux
  • Humans
  • Laparoscopy
  • Laparotomy
  • Length of Stay
  • Markov Chains
  • Omeprazole
  • Poland
  • Postoperative Complications
  • Reoperation
  • Treatment Outcome
  • drug therapy
  • economics
  • surgery
  • therapy
  • hsrmtgs

General Notes:

  • Meeting held in: Italy

NLM Unique ID: 101252625
UI: 103141160
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