Abstract:
:Barrett's oesophagus is a premalignant complication that occurs in approximately 10% of patients with gastro-oesophageal reflux disease (GORD). In patients with Barrett's oesophagus, the risk of adenocarcinoma of the oesophagus approaches 0.5% per patient-years. Therefore, practice guidelines have been developed that suggest screening patients with GORD, particularly those with long-standing symptoms and those aged > or =50 years for the presence of Barrett's metaplasia. These guidelines also suggest performing surveillance endoscopy for the development of dysplasia and/or cancer in patients found to harbour Barrett's oesophagus at initial screening with the frequency of subsequent endoscopies dictated by the presence and grade of dysplasia. In patients with high-grade dysplasia and/or early adenocarcinoma, oesophagectomy is curative. Given the important clinical and economic implications of GORD complicated by Barrett's oesophagus, we review the costs associated with screening, surveillance and treatment for this condition. Although the majority of physicians recommend and/or perform surveillance for dysplasia in the setting of Barrett's oesophagus, differences in endoscopic technique, surveillance intervals and cancer perception among practitioners influence total costs. In the US, it is estimated that a population-wide surveillance program could potentially result in a total cost of 289.9 million US dollars. The outpatient management of Barrett's oesophagus is estimated to cost 1241 US dollars per year with medication use alone accounting for over half of the total costs. Cost-effectiveness analyses have been performed to evaluate the economic impact and benefit of surveillance for dysplasia and/or cancer. Studies to date have utilised several outcome measures such as life-years gained, quality-adjusted life-years and cases of cancer detected. Therefore, the incremental cost-effectiveness ratios reported have varied greatly and are particularly sensitive to the prevalence of Barrett's oesophagus in patients with GORD and the incidence of adenocarcinoma. Further epidemiological and clinical studies are likely to further define the economic impact of Barrett's oesophagus as a complication of GORD.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Arguedas MR,Eloubeidi MAdoi
10.2165/00019053-200119100-00003subject
Has Abstractpub_date
2001-01-01 00:00:00pages
1003-11issue
10eissn
1170-7690issn
1179-2027pii
191003journal_volume
19pub_type
杂志文章,评审abstract:BACKGROUND:A wide variety of oral antiplatelet trials have been carried out, and a large number of cost-effectiveness estimates based on them have been published. OBJECTIVE:To assess the cost effectiveness of oral antiplatelet treatments in the prevention of cardiovascular events. METHODS:A comprehensive literature s...
journal_title:PharmacoEconomics
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doi:10.2165/00019053-200725120-00007
更新日期:2007-01-01 00:00:00
abstract::Cost-effectiveness analysis (CEA) is one of the main tools of economic evaluation. Every CEA is based on a number of assumptions, some of which may not be accurate, introducing uncertainty. Sensitivity analysis (SA) formalizes ways to measure and evaluate this uncertainty. Specific sources of uncertainty in CEA have b...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/11584630-000000000-00000
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doi:10.1007/s40273-017-0541-1
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199610040-00007
更新日期:1996-10-01 00:00:00
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journal_title:PharmacoEconomics
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doi:10.2165/00019053-200220010-00003
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更新日期:2007-01-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200422001-00002
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更新日期:2007-01-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11312720-000000000-00000
更新日期:2009-01-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
doi:10.2165/00019053-199711060-00005
更新日期:1997-06-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-015-0312-9
更新日期:2015-10-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199610060-00006
更新日期:1996-12-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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更新日期:2018-12-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/11589270-000000000-00000
更新日期:2012-04-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199200011-00010
更新日期:1992-01-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11597890-000000000-00000
更新日期:2012-08-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199814002-00003
更新日期:1998-01-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199610020-00009
更新日期:1996-08-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199813060-00001
更新日期:1998-06-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199712060-00008
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease associated with increasing morbidity and mortality and an economic burden that stretches beyond the patient to healthcare systems. Avoiding exacerbations and subsequent hospitalizations is an important clinical aim and ca...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11590380-000000000-00000
更新日期:2011-05-01 00:00:00
abstract::In an attempt to obtain an appropriate estimate of the excess costs of production losses arising from morbidity in patients with diabetes, we compared the number of sick days and permanently disabled individuals in a diabetic population and the corresponding general population. These comparisons show that the rate of ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199500081-00007
更新日期:1995-01-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章
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更新日期:2015-01-01 00:00:00
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更新日期:2017-02-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章
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更新日期:2002-01-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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更新日期:2006-01-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199202050-00005
更新日期:1992-11-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200725060-00001
更新日期:2007-01-01 00:00:00