title: Costs and efficacy of three different esomeprazole treatment strategies for long-term management of gastro-oesophageal reflux symptoms in primary care.
abstract: BACKGROUND
  A prospective, open, randomized multi-centre study with parallel group design was conducted in 155 general practice clinics, and included 1357 endoscopically uninvestigated patients with symptoms suggestive of gastro-oesophageal reflux disease.
  
  
  OBJECTIVE
  To assess the differences in direct medical costs between a patient-controlled on-demand treatment strategy with esomeprazole, 20 mg daily, and general practitioner-controlled intermittent treatment strategies with esomeprazole, 40 mg daily, for either 2 or 4 weeks. Secondary objectives were to measure other costs, total costs, patient satisfaction and time to first relapse.
  
  
  METHODS
  The primary cost analysis was carried out as a cost minimization analysis, comparing the direct medical costs in patients allocated to on-demand treatment vs. those in patients allocated to either of the intermittent treatment strategies.
  
  
  RESULTS
  The mean direct medical costs were 182, 221 and 195 euros for patient-controlled on-demand treatment and 2 weeks and 4 weeks of general practitioner-controlled intermittent treatment, respectively, showing no statistically significant difference. The comparable mean total costs were 211, 344 and 300 euros, i.e. significantly lower for patients treated on-demand compared with either of the general practitioner-controlled intermittent treatment strategies.
  
  
  CONCLUSIONS
  The mean total costs, but not the mean direct medical costs, were higher in general practitioner-controlled intermittent treatment strategies with esomeprazole compared with a patient-controlled on-demand treatment strategy.
authors.affiliation: vms@dadlnet.dk
authors.forename: V
authors.initials: V
authors.lastname: Meineche-Schmidt
authors.forename: H Hauschildt
authors.initials: HH
authors.lastname: Juhl
authors.forename: J E
authors.initials: JE
authors.lastname: Østergaard
authors.forename: A
authors.initials: A
authors.lastname: Luckow
authors.forename: A
authors.initials: A
authors.lastname: Hvenegaard
mesh_terms: D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000191:economics*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D064098:Esomeprazole / Q000008:administration & dosage / Q000191:economics*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016896:Treatment Outcome
chemical_list: D000897:Anti-Ulcer Agents; D064098:Esomeprazole