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Updated: May 16, 2025
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Author Spotlight: Advancing Biopsy Techniques with Transesophageal Ultrasound
Published on: November 21, 2023
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Incidental downstream resource utilization due to endoscopic screening for Barrett's esophagus
Matthew Harbrecht1, Maria E Arasim2, Yue Liu1
1Barrett's Esophagus Program, Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Summary
Screening for Barrett's esophagus (BE) via esophagogastroduodenoscopy (EGD) incurs modest additional costs from incidental findings like biopsies and acid suppression. These resource utilization factors should inform future cost-effectiveness analyses.
Area of Science:
- Gastroenterology
- Health Economics
Background:
- Cost-effectiveness analyses (CEA) for Barrett's esophagus (BE) screening exist.
- These analyses often exclude resource utilization from incidental findings during esophagogastroduodenoscopy (EGD).
Purpose of the Study:
- To quantify the additional resource utilization and costs associated with incidental findings during EGD for BE screening.
- To inform future CEA by including these previously overlooked costs.
Main Methods:
- Longitudinal data from 822 male patients aged 50-79 undergoing research EGD for BE screening were analyzed.
- Costs were estimated using Medicare reimbursements and medication wholesale prices.
- Resource utilization included biopsies, acid suppression recommendations, and repeat EGDs.
Main Results:
- Nearly one-third of patients (32.4%) had gastric biopsies.
- 15.7% were recommended acid suppression.
- Repeat EGDs, recommended in 2.0%, represented the second highest weighted resource cost.
- The total additional expected cost from incidental findings was $66 per EGD.
Conclusions:
- Incidental findings during EGD for BE screening lead to a modest increase in resource utilization.
- Biopsies and acid suppression are primary drivers of these additional costs.
- These findings necessitate their inclusion in future BE screening CEA.
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