Time trends in cost of caring for people with gastroesophageal reflux disease

OBJECTIVE: Increasing acceptance of the many permutations of gastroesophage al reflux disease (GERD) has led to diverse study of the disease and its ef fects. The goal of this study was to estimate medical care costs attributab le to a defined GERD population over time. METHODS: A retrospective cohort control design was used All participants we re identified from the database of a managed care organization serving 300, 000 people in the northeastern United States. The index population (n = 600 ) was defined as anyone who obtained medical services during 1997 or 1998. for any International Classification of Diseases (ninth revision, Clinical Modification) codes suggestive of GERD, and/or anyone who received at least one prescription and one refill for antisecretory or GERD medications duri ng at least two 3-month periods in 1997 or 1998. A matched cohort (n = 600) without any diagnosis of GERD was randomly selected as a control group. Bo th populations were observed restrospectively from January 1, 1990 through December 31, 1998. RESULTS: The cost of treating GERD averaged around $510 per year, about 15% of all medical costs for those with GERD. Treating people with GERD was ab out 2-fold more costly than treating those without GERD, a marginal cost of $1500 to $2000 per annum. CONCLUSION: Although GERD is a low-cost disease to treat, the cost of treat ing people with GERD is subtantially greater than that for a comparable pop ulation without GERD. Two explanations may account for the large difference of costs between the study populations. First, the GERD group may be sicke r than the control group. Disease severity variables and diagnoses associat ed with GERD were more commonly diagnosed in the GERD group. Second, an add itional disease that is not treated appropriately increases the cost of tre atment geometrically for all diseases. (C) 2001 by Am. Coll. of Gastroenter ology.