Extraesophageal symptoms are common manifestations of gastroesophageal reflux disease.
Lack of a definitive diagnostic or treatment standards complicate management, which often leads to multiple specialty consultations, procedures, pharmaceuticals and diagnostic tests.
Dr David Francis and colleagues from Tennessee, USA reported determined the economic burden associated with extraesophageal reflux.
Direct costs of evaluation were estimated for patients referred with symptoms attributed to extraesophageal reflux between 2007 and 2011.
Medicare payment for evaluation and management and pharmaceutical prices was used to calculate first year, and overall costs of evaluating and treating extraesophageal symptoms attributed to reflux.
The research team noted that overall, 281 patients were studied, included symtpoms for hoarseness, globus/post-nasal drainage, asthma, and sore throat.
Over a median of 32 months follow-up, patients had a mean of 10 consultations with specialists, and underwent 6 diagnostic procedures.
Overall, the mean initial year direct cost was $5,438 per patient being evaluated for extraesophageal reflux.
|52% of costs were attributable to the use of proton pump inhibitors|
|American Journal Of Gastroenterology|
The doctors reported that the medical and non-medical components contributed $5,154 and $283, respectively.
Of the overall cost, 52% were attributable to the use of proton pump inhibitors.
The team of doctors found that during the initial year, direct costs were 6 times higher than those reported for typical gastroesophageal reflux disease.
A total of 54% of patients reported improvement of symptoms.
Overall cost per improved patient was $13,700.
Dr Francis's team concluded, "Extraesophageal reflux contributes substantially to health-care expenditures."
"In this cohort, the cost for initial year's evaluation and treatment of extraesophageal reflux symptoms was quintuple that of typical gastroesophageal reflux disease."
"Prescription costs and, in particular, proton pump inhibitors were the single greatest contributor to the cost of extraesophageal reflux management."