Heartburn Relief Is the Major Unmet Need for Drug Development in Gastroesophageal Reflux Disease: Threshold Value...

Area of Science:

• Gastroenterology
• Pharmacoeconomics
• Health Services Research

Background:

• Heartburn symptoms are a primary driver for healthcare utilization in gastroesophageal reflux disease (GERD).
• Current GERD management is often constrained by insurance restrictions, impacting treatment choices.
• Potassium-competitive acid blockers (PCABs) represent a new therapeutic class under development for GERD.

Purpose of the Study:

• To conduct economic analyses of novel GERD therapies within a value-based healthcare environment.
• To evaluate the cost-effectiveness of PCABs compared to existing treatments and no treatment.
• To align drug development incentives for industry, insurers, patients, and clinicians.

Main Methods:

• A decision-analytic model was developed to compare vonoprazan (a PCAB) at 20 mg daily with standard proton pump inhibitor (PPI) regimens and no treatment over a one-year period.
• Clinical efficacy was assessed based on heartburn-free days from a phase 3 trial.
• Healthcare utilization data for GERD were obtained from national observational studies.

Main Results:

• Inadequately treated GERD costs patients an average of $4443 and insurers $3784 annually.
• PCABs have the potential to save at least $3000 annually in costs for both patients and insurers.
• PCABs could offer quality-adjusted life year gains of +0.06 per year and be cost-saving for insurers if priced up to $8.57 per pill, assuming comparable efficacy to PPIs.

Conclusions:

• Drug development for GERD should prioritize heartburn relief to create aligned cost-effective incentives.
• PCABs show promise as a cost-effective treatment option for GERD, potentially benefiting all stakeholders.
• Economic evaluations are crucial for guiding the development and adoption of new GERD therapies.