LIFETIME COSTS OF SURGICAL VERSUS MEDICAL-TREATMENT OF SEVERE GASTROESOPHAGEAL REFLUX DISEASE IN FINLAND

Background: Gastro-oesophageal reflux disease (GERD) can be effectivel y treated pharmacologically or surgically. As GERD is often a chronic condition, we compared the long-term costs of medical and surgical man agement. 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 on e-third of that time. Costs for open or laparoscopic surgery (Nissen f undoplication) included pre- and post-operative investigations, sick l eave, and calculated financial loss due to fatal outcome. Results: Cos ts were lowest with ranitidine, 150 mg/day, for one-third of the patie nt's lifetime and highest with lifelong omeprazole, 40 mg/daily. The c ost of open or laparoscopic operation was less than that of lifelong d aily treatment with proton pump inhibitors or ranitidine, 300 mg daily . Conclusion: In Finland, antireflux surgery for GERD is cheaper than lifetime treatment with proton pump inhibitors.