Chin Hur, MD, a gastroenterologist at Boston-based Massachusetts General Hospital, and colleagues developed a model to analyze cost effectiveness in screening patients with GERD who are at risk for Barrett’s esophagus. They compared Cytosponge to endoscopy-only screening.
Researchers used data from a clinical trial of Cytosponge performance. They incorporated that data into two esophageal adenocarcinoma progression models. With both models, researchers determined what method would be most cost effective for a 60-year-old, male patient with GERD.
Here’s what they found:
1. The Cytosponge with a follow-up endoscopy to confirm positive results reduces screening costs by 27 percent to 29 percent.
2. However, the Cytosponge led to 1.8 to 5.5 fewer quality-adjusted life years per 1,000 patients.
3. The Cytosponge’s incremental cost-effectiveness ratios when patients weren’t screened with an endoscopy [A2] ranged from $26,358 to $33,307. When patients were screened by an endoscopy, the incremental cost-effectiveness ratios were between $107,583 and $330,361.
Researchers concluded, “In a comparative modeling analysis of screening strategies for BE in patients with GERD, we found Cytosponge screening with endoscopic confirmation to be a cost-effective strategy. The greatest benefit was achieved by endoscopic screening, but with an unfavorable cost margin.”
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