Cost effectiveness of treatment for gastro-oesophageal reflux disease in clinical practice
Editor,—I was interested to read the paper by Eggleston et al (Gut1998;42:13–16) purporting to show that a “step up” approach using prokinetics and H2 receptor antagonists in the management of gastro-oesophageal reflux disease (GORD) is more cost effective than omeprazole in a general practice setting. I do not think the conclusions drawn are supported by data presented.
The MediPlus database does not permit systematic evaluation of the severity of GORD symptoms and so there is no certainty that the three patient groups (who received omeprazole, ranitidine or cisapride) were comparable. Patients were excluded from the study …
