Laparoscopic nissen fundoplication reduces pharmacy costs in GERD

Abstract

INTRO: In addition to providing symptom relief and preventing complications of GERD, the laparoscopic Nissen fundoplication has been promoted as a cost-saving operation to reduce the use of GI medications. PURPOSE: Retrospectively analyze the use of ormedications before and after laparoscopic Nissen fundoplication. METHODS: From a database of 200.000 covered patient lives in a large managed care plan, all individuals who underwent laparoscopic Nissen fundoplication from 1-1-98 to 6-30-98 were analyzed via paid claims data retrospectively for prescriptions of antisecretory and prokinetic medications. Only members continuously enrolled in the program from 7-1-97 to 12-3 1-98 were studied. RESULTS: 17 patients (9M, 8F; mean age=44 yrs) underwent laparoscopic Nissen fundoplication during the study period. In the 6 months priorto surgery, 17/17 patients received 110 prescriptions with a total cost of $10,245 and an average cost of $99.38/pt/mo. In the 6 months aft er laparoscopic Nissen fundoplication, only 3/ 17 patients received a total of ten prescriptions for ormedications at a total cost of $595 and an average cost of $5.85/pt/mo. CONCLUSION: In the six month period following surgery, laparoscopic Nissen fundoplication was associated with significant reduction in the number of patients requiring medication for GERO, reduced total costs for GI medications and reductions in medication costs for those few patients requiring continuing medical therapy.