Lifetime costs of surgical versus medical treatment of severe gastro-oesophageal reflux disease in Finland.
BACKGROUND
Gastro-oesophageal reflux disease (GERD) can be effectively treated pharmacologically or surgically. As GERD is often a chronic condition, we compared the long-term costs of medical and surgical management.


METHODS
The medical regimens were ranitidine (150 or 300 mg/day), omeprazole (20 or 40 mg/day), and lansoprazole (30 mg/day), with costs calculated for total life expectancy after diagnosis and for one-third of that time. Costs for open or laparoscopic surgery (Nissen fundoplication) included pre- and post-operative investigations, sick leave, and calculated financial loss due to fatal outcome.


RESULTS
Costs were lowest with ranitidine, 150 mg/day, for one-third of the patient's lifetime and highest with lifelong omeprazole, 40 mg/daily. The cost of open or laparoscopic operation was less than that of lifelong daily treatment with proton pump inhibitors or ranitidine, 300 mg daily.


CONCLUSIONS
In Finland, antireflux surgery for GERD is cheaper than lifetime treatment with proton pump inhibitors.
Viljakka
M
M
Medical School, Dept. of Surgery, University of Tampere, Finland.
Nevalainen
J
J
Isolauri
J
J
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002908:Chronic Disease; D017281:Cost of Illness; D004791:Enzyme Inhibitors / Q000191:economics*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D018662:Fundoplication / Q000191:economics* / Q000379:methods; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000191:economics* / Q000601:surgery; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D064747:Lansoprazole; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D011446:Prospective Studies; D054328:Proton Pump Inhibitors; D011788:Quality of Life; D011899:Ranitidine / Q000191:economics / Q000627:therapeutic use
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D011899:Ranitidine; D009853:Omeprazole