Tabaeian Seidamir Pasha, Moeini Sajad, Rezapour Aziz, Afshari Somayeh, Souresrafil Aghdas, Barzegar Mohammad
1Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Department of Health Services Management, School of Health Management & Information Sciences, Iran University of Medical Sciences, Tehran, Iran
BMJ Open Gastroenterol. 2024 Dec 20;11(1):e001465. doi: 10.1136/bmjgast-2024-001465.
Our aim was to systematically review the cost-effectiveness of proton pump inhibitor (PPI) therapies and surgical interventions for gastro-oesophageal reflux disease (GORD).
The study design was a systematic review of economic evaluations.
We searched PubMed, Embase, Scopus, and Web of Science for publications from January 1990 to March 2023. Only articles published in English were eligible for inclusion.
Studies were included if they were full economic evaluations comparing PPIs with surgical or alternative therapies for GORD. Excluded were narrative reviews, non-peer-reviewed articles, and studies not reporting cost-effectiveness outcomes.
Two reviewers independently extracted data on study design, comparators, time horizon, and cost-effectiveness outcomes. The quality of studies was assessed using the Joanna Briggs Institute (JBI) checklist for economic evaluations.
A total of 25 studies met the inclusion criteria. Laparoscopic Nissen fundoplication (LNF) was found to be cost-effective in long-term horizons, while PPIs were preferred for short- to medium-term outcomes. Differences in healthcare settings and methodological approaches influenced the study findings.
Strategic purchasing decisions for GORD treatment should consider the time horizon, healthcare setting, and cost structures. LNF may provide better long-term value, but PPIs remain effective for managing symptoms in the short term.
PROSPERO, CRD42023474181.
我们的目的是系统评价质子泵抑制剂（PPI）疗法和手术干预对胃食管反流病（GORD）的成本效益。
研究设计为对经济评估的系统评价。
我们在PubMed、Embase、Scopus和Web of Science中检索了1990年1月至2023年3月的出版物。仅纳入以英文发表的文章。
如果研究是比较PPI与GORD的手术或替代疗法的全面经济评估，则纳入研究。排除叙述性综述、非同行评审文章以及未报告成本效益结果的研究。
两名评审员独立提取关于研究设计、对照、时间范围和成本效益结果的数据。使用乔安娜·布里格斯研究所（JBI）经济评估清单评估研究质量。
共有25项研究符合纳入标准。发现腹腔镜下尼森胃底折叠术（LNF）在长期来看具有成本效益，而PPI在短期至中期结果方面更受青睐。医疗环境和方法学方法的差异影响了研究结果。
GORD治疗的战略采购决策应考虑时间范围、医疗环境和成本结构。LNF可能提供更好的长期价值，但PPI在短期内仍能有效控制症状。
PROSPERO，CRD42023474181。
