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Disease-related costs decrease after GERD procedure
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Treating patients with GERD with magnetic sphincter augmentation using the Linx Reflux Management System helped reduce disease-related and overall medical costs in the year following surgery, according to study results.
“The higher initial cost of a Linx procedure compared to a Nissen fundoplication is perceived as a drawback by insurers, which made getting insurance approvals challenging,” Blair Jobe, MD, director of the Esophageal and Lung Institute at Allegheny Health Network, said in a press release.
In a prospective observational study presented at the Annual Meeting of the Society of Gastrointestinal and Endoscopic Surgeons, researchers compared the cost, as well as the disease-related and overall expense of the magnetic sphincter augmentation (MSA) using Linx (Ethicon) with the laparoscopic Nissen fundoplication (LNF).
They collected data from 180 patients who underwent MSA over a 2 year period starting in 2015 and 1,131 patients who underwent LNF to find the total procedural costs, as well as the disease-related and overall medical claims submitted 12 months before and after surgery.
Among patients who underwent MSA, the median (interquartile range [IQR]) cost of surgery was $13,522 ($13,195–$14,439) compared with $13,388 ($9,951–$16,261; P = .02) among patients who underwent LNF.
However, the median reimbursement related to upper gastrointestinal disease in patients who underwent MSA decreased from $305 per member per month (PMPM) at 12 months prior to surgery to $104 PMPM 12 months after surgery, a 66% decrease. Reimbursements for disease-related costs also went down for patients who underwent LNF ($223 to $126, 46% decrease), but the decrease was significantly higher for the MSA procedure (P = .0001).
Jobe and colleagues also found that overall PMPM medical reimbursement claims decreased by 10.7% for patients who underwent MSA compared with just 1.4% in patients who underwent LNF.
Jobe said their findings show that these cost decreases after surgery make up for the initial cost of MSA.
“This study suggests that perception may be short-sighted in that insurance plans can provide better care for their GERD patients at a similar cost to laparoscopic Nissen fundoplication when you factor in the greater reductions in medical costs after the procedure,” he said in the release. – by Alex Young
Disclosures: Jobe reports that he is a consultant for Ethicon.