PGI15 ONE-YEAR RESOURCE USE FOR MEDICATION-REFRACTORY GASTROESOPHAGEAL REFLUX DISEASE PATIENTS TREATED WITH LAPAROSCOPIC NISSEN FUNDOPLICATION OR LINX REFLUX MANAGEMENT SYSTEM: A SURVEY OF 99 U.S. CLINICIANS

Abstract

Gastroesophageal reflux disease (GERD) is a common condition, with a large proportion of patient’s refractory to medical management (rMM). Treatment options for rMM has been limited to laparoscopic Nissen Fundoplication (LNF) which has been associated with several complications. Technologies such as the LINX Reflux Management System (MSA) have emerged with demonstrated clinical benefits, however, resource use data are limited. This study sought to compare the 1-year resource use with MSA and LNF through a clinician survey. A survey was developed to capture resources with MSA and LNF use including pre-op/post-op/ongoing- diagnostics, intra/post-operative resources (ie, consumables, drugs, lab tests, etc.), readmissions, re-operations, and follow-up visits. Survey development utilized published literature and input from key opinion leaders. The survey was administered to two U.S. clinical stakeholder types: GIs and surgeons that refer patients and perform GERD procedures. Participants were recruited through large physician and surgeon databases to identify qualified respondents. Inclusion in the study required participants to be expertly familiar with MSA and LNF procedures. Administration of the survey was conducted via an online survey instrument. A total of 99 clinicians completed the survey (50 GIs and 49 surgeons). In general, responses were similar between clinicians, though differences were reported in consumables and follow-up tests. Key benefits anticipated with the MSA compared to LNF included reductions in procedural consumables, intra-/post-operative drugs, readmission rates, physician/outpatient visits, and 1-year follow-up tests. A larger proportion of MSA procedures were expected to be performed in an outpatient setting. Resources anticipated to be similar between MSA and LNF included diagnostic tests performed prior to the procedure. According to the survey, treatment of GERD patients who are unresponsive to medical therapy with MSA is anticipated to result in reduced overall hospital resource use compared to LNF. In adopting MSA, this finding may have important economic implications for hospitals.