Quality of Life and Cost of Therapy in Reflux Disease

Abstract

BACKGROUND AND RESULTS IN THE LITERATURE: Reflux symptoms are common, with an incidence of up to 40% monthly and 7% daily in the general adult population. The duration of symptoms in patients seeking help for reflux is often in excess of 5 years in an unselected population. A majority, 70%, of those with daily symptoms do not have esophagitis at endoscopy but still require regular medication for symptom control. After treatment, relapse is seen in a majority of cases in whom esophagitis is present at start of therapy. Symptoms of reflux and upper abdominal dyspepsia affect several aspects of daily living. Consequently quality of life (QoL) is low in patients with reflux esophagitis and upper dyspepsia. Values normalize during medical treatment or after surgery for reflux esophagitis. Cost of treatment is complex. Evaluations in patients with reflux esophagitis are based on the effectiveness and cost of the drug, the cost of investigations and time lost from work. In comparisons based on the results of clinical healing trials, omeprazole has been found the most cost-effective drug for treatment of reflux esophagitis. There are as yet no evaluations made for patients with reflux symptoms only. The consequences for the patient and society regarding QoL and costs for reflux symptoms should be evaluated more closely to optimize future therapy.