Cost-effectiveness of different diagnostic strategies to assess gastro-oesophageal reflux disease in patients with unexplained chronic persistent cough in Italy

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
F BaldiE Roda

Abstract

Chronic persistent cough is a common and disabling disorder and gastro-oesophageal reflux disease is considered to be the third leading cause, after asthma and postnasal drip. Therefore, patients with unexplained chronic persistent cough usually undergo a stepwise evaluation to establish the existence of a reflux disease. To identify the most cost-effective diagnostic approach to assess gastro-oesophageal reflux disease in patients with unexplained chronic persistent cough. Direct and indirect costs associated with six diagnostic strategies using 24-h oesophageal pH-metry, oesophago-gastroduodenoscopy and the proton pump inhibitors test in different sequences, were evaluated using a decision tree model. If the first test was positive, the diagnostic work-up was stopped, if negative the patient proceeded to the second test, and so on. Clinical data from an observational prospective trial conducted in 51 patients with unexplained chronic persistent cough were used in the economic model. All six strategies had the same clinical effectiveness (78.4%). The diagnostic work-up with the lowest cost was the proton pump inhibitors test followed by pH-metry and then oesophago-gastroduodenoscopy with a total cost of euro 211.08 (direct eur...Continue Reading

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Citations

May 9, 2014·PharmacoEconomics·Andrew J GawronColin W Howden
Aug 28, 2016·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Luciana Scalone, Paolo A Cortesi
Nov 6, 2007·Nature Clinical Practice. Gastroenterology & Hepatology·K M Dinesh Chandra, Susan M Harding
Jan 21, 2011·The Cochrane Database of Systematic Reviews·Anne B ChangLuke A Garske

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