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Healthcare costs of GERD and acid-related conditions in pediatric patients, with comparison between histamine-2 receptor antagonists and proton pump inhibitors.
Curr Med Res Opin. 2009 Nov; 25(11):2703-9.CM

Abstract

BACKGROUND

Gastroesophageal reflux disease and acid-related conditions (GERD/ARC) are common in pediatric practice but their costs have not been well characterized.

AIM

To compare healthcare costs (HCC) and healthcare utilization (HCU) of pediatric GERD/ARC between groups of GERD/ARC patients initiated on histamine-2 receptor antagonists (H(2)RAs) or proton pump inhibitors (PPIs) and matched controls.

PATIENTS AND METHODS

Children (age < 18 years) diagnosed with GERD or ARC (exploratory category) were identified from a large US claims database (1999-2005) using ICD-9 codes. Costs of pediatric GERD/ARC were estimated by comparing 6-month post-diagnosis HCC between cases and matched controls. GERD/ARC-related HCC and HCU for the year 2005 were further compared between GERD/ARC patients initiated with PPIs vs. H(2)RAs in terms of the cost differences relative to pre-initiation (difference-in-difference) and using multivariate regression to adjust for demographics, pre-treatment health status and pre-treatment costs.

RESULTS

A total of 27 865 matched pairs were identified. GERD/ARC patients incurred on average more 6-month total HCC than controls ($2386). In 2005, 1010 pediatric patients were initiated on H(2)RAs or PPIs. About 61% were initiated on PPIs and incurred 1.8 times higher 6-month post-initiation GERD/ARC-related HCC than H(2)RA-initiated patients ($661 vs. $372, p < 0.001). Although total 6-month GERD/ARC-related HCC increased for both PPI- and H(2)RA-treated patients, the increase was 30% less for PPI-treated patients ($173 vs. $246, p = 0.521) in the difference-in-difference analysis and 69% less in the multivariate analysis ($109 vs. $347, p = 0.040).

LIMITATIONS

The use of an exploratory definition for GERD/ARC, administrative claims data and potential coding errors in diagnosis codes used in selection process may limit the generalizability of the results.

CONCLUSION

Pediatric GERD/ARC patients incurred significantly higher healthcare costs compared to similar children without GERD/ARC. Compared to patients initiated with H(2)RAs, patients initiated with PPIs had more baseline comorbidities, and lower GERD/ARC-related HCC after beginning treatment.

Authors+Show Affiliations

Astellas Pharma US, Inc., Deerfield, IL, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19775195

Citation

Kothari, S, et al. "Healthcare Costs of GERD and Acid-related Conditions in Pediatric Patients, With Comparison Between Histamine-2 Receptor Antagonists and Proton Pump Inhibitors." Current Medical Research and Opinion, vol. 25, no. 11, 2009, pp. 2703-9.
Kothari S, Nelson SP, Wu EQ, et al. Healthcare costs of GERD and acid-related conditions in pediatric patients, with comparison between histamine-2 receptor antagonists and proton pump inhibitors. Curr Med Res Opin. 2009;25(11):2703-9.
Kothari, S., Nelson, S. P., Wu, E. Q., Beaulieu, N., McHale, J. M., & Dabbous, O. H. (2009). Healthcare costs of GERD and acid-related conditions in pediatric patients, with comparison between histamine-2 receptor antagonists and proton pump inhibitors. Current Medical Research and Opinion, 25(11), 2703-9. https://doi.org/10.1185/03007990903307755
Kothari S, et al. Healthcare Costs of GERD and Acid-related Conditions in Pediatric Patients, With Comparison Between Histamine-2 Receptor Antagonists and Proton Pump Inhibitors. Curr Med Res Opin. 2009;25(11):2703-9. PubMed PMID: 19775195.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Healthcare costs of GERD and acid-related conditions in pediatric patients, with comparison between histamine-2 receptor antagonists and proton pump inhibitors. AU - Kothari,S, AU - Nelson,S P, AU - Wu,E Q, AU - Beaulieu,N, AU - McHale,J M, AU - Dabbous,O H, PY - 2009/9/25/entrez PY - 2009/9/25/pubmed PY - 2009/12/30/medline SP - 2703 EP - 9 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 25 IS - 11 N2 - BACKGROUND: Gastroesophageal reflux disease and acid-related conditions (GERD/ARC) are common in pediatric practice but their costs have not been well characterized. AIM: To compare healthcare costs (HCC) and healthcare utilization (HCU) of pediatric GERD/ARC between groups of GERD/ARC patients initiated on histamine-2 receptor antagonists (H(2)RAs) or proton pump inhibitors (PPIs) and matched controls. PATIENTS AND METHODS: Children (age < 18 years) diagnosed with GERD or ARC (exploratory category) were identified from a large US claims database (1999-2005) using ICD-9 codes. Costs of pediatric GERD/ARC were estimated by comparing 6-month post-diagnosis HCC between cases and matched controls. GERD/ARC-related HCC and HCU for the year 2005 were further compared between GERD/ARC patients initiated with PPIs vs. H(2)RAs in terms of the cost differences relative to pre-initiation (difference-in-difference) and using multivariate regression to adjust for demographics, pre-treatment health status and pre-treatment costs. RESULTS: A total of 27 865 matched pairs were identified. GERD/ARC patients incurred on average more 6-month total HCC than controls ($2386). In 2005, 1010 pediatric patients were initiated on H(2)RAs or PPIs. About 61% were initiated on PPIs and incurred 1.8 times higher 6-month post-initiation GERD/ARC-related HCC than H(2)RA-initiated patients ($661 vs. $372, p < 0.001). Although total 6-month GERD/ARC-related HCC increased for both PPI- and H(2)RA-treated patients, the increase was 30% less for PPI-treated patients ($173 vs. $246, p = 0.521) in the difference-in-difference analysis and 69% less in the multivariate analysis ($109 vs. $347, p = 0.040). LIMITATIONS: The use of an exploratory definition for GERD/ARC, administrative claims data and potential coding errors in diagnosis codes used in selection process may limit the generalizability of the results. CONCLUSION: Pediatric GERD/ARC patients incurred significantly higher healthcare costs compared to similar children without GERD/ARC. Compared to patients initiated with H(2)RAs, patients initiated with PPIs had more baseline comorbidities, and lower GERD/ARC-related HCC after beginning treatment. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/19775195/Healthcare_costs_of_GERD_and_acid_related_conditions_in_pediatric_patients_with_comparison_between_histamine_2_receptor_antagonists_and_proton_pump_inhibitors_ L2 - https://www.tandfonline.com/doi/full/10.1185/03007990903307755 DB - PRIME DP - Unbound Medicine ER -