title: Medical cost, incidence rate, and treatment status of gastroesophageal reflux disease in Japan: analysis of claims data.
abstract: OBJECTIVE
  Published reports have shown the prevalence and incidence of gastroesophageal reflux disease (GERD) is increasing in Japan. The objective of this study is to examine change in GERD incidence, and to understand current patient demographics, medical costs, treatment status, and the suitability of current treatment based on analysis of an insurance claims database.
  
  
  METHODS
  An insurance claims database with data on ∼1.9 million company employees from January 2005 to May 2015 was used. Prevalence, demographics, and medical costs were analyzed by cross-sectional analysis, and incidence and treatment status were analyzed by longitudinal analysis among newly-diagnosed GERD patients.
  
  
  RESULTS
  GERD prevalence in 2014 was 3.3% among 20-59 year-olds, accounting for 40,134 people in the database, and GERD incidence increased from 0.63% in 2009 to 0.98% in 2014. In 2014, mean medical cost per patient per month for GERD patients aged 20-59 was JPY 31,900 (USD 266 as of January 2016), which was ∼2.4-times the mean national healthcare cost. The most frequently prescribed drugs for newly-diagnosed GERD patients were proton pump inhibitors (PPIs). Although PPIs were prescribed more often in patients with more doctor visit months, over 20% of patients that made frequent doctor visits (19 or more visits during a 24 calendar months period) were prescribed PPIs during only 1 calendar month or not at all.
  
  
  CONCLUSIONS
  The database included only reimbursable claims data and, therefore, did not cover over-the-counter drugs. The database also consisted of employee-based claims data, so included little data on people aged 60 years and older.
  
  
  CONCLUSIONS
  Given the increasing incidence of GERD in Japan there is a need for up-to-date information on GERD incidence. This study suggests that some GERD patients may not be receiving appropriate treatment according to Japanese guidelines, which is needed to improve symptom control.
authors.affiliation: a Division of Gastroenterology , Department of Internal Medicine, Hyogo College of Medicine , Hyogo , Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Miwa
authors.affiliation: b Milliman Inc , Tokyo , Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Takeshima
authors.affiliation: b Milliman Inc , Tokyo , Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Iwasaki
authors.affiliation: c Global Medical Affairs - Japan, Takeda Pharceutical Company Limited , Tokyo , Japan.|d Department of Pharmacoepidemiology , Graduate School of Medicine and Public Health, Kyoto University , Kyoto , Japan.
authors.forename: Shinzo
authors.initials: S
authors.lastname: Hiroi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000453:epidemiology*; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D007345:Insurance Claim Review; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000191:economics*; D055815:Young Adult
chemical_list: D054328:Proton Pump Inhibitors
keywords: Claims database analysis; Gastroesophageal reflux disease; Health economics; Histamine H2 receptor antagonist; Proton pump inhibitor