Treatment of gastroesophageal reflux disease in a managed care environment. Based on a presentation by Kevin Ashby, MD.

Acid-related diseases, such as gastroesophageal reflux disease (GERD), have a significant impact on healthcare costs. As a result, healthcare providers must devise ways to limit expenditures while providing high-quality patient care. Although the goals of therapy are the same in both traditional fee-for-service and managed care environments, optimal cost-containment strategies depend heavily on the specifics of payment and risk arrangements involved. Cost-saving strategies involving drug therapy are often based on the assumption that treatments with lower acquisition costs are the most cost effective. In the case of GERD treatment, the respective efficacies of acid-suppression therapies should also be considered. In addition, efficacy should be a major consideration in therapy choice because GERD recurrence and complications as a result of ineffective therapies can negatively affect patients' quality of life and increase the overall cost of healthcare. The advantages and limitations of endoscopy as a prognostic tool should also be considered in an assessment of cost-effective GERD treatment.