A cost analysis of gastro-oesophageal reflux disease and dyspepsia in Iran

Background and aimTo provide a first-time report on the health care utilization and costs of gastro-oesophageal reflux disease and dyspepsia in Iran.MethodsA consecutive sample of 501 patients referred for upper endoscopy to an outpatient gastroenterology clinic in central Tehran (May 2005 to January 2006) was investigated using two interview-assisted questionnaires for gastro-oesophageal reflux disease (i.e. heartburn or regurgitation on a weekly basis for at least the past 3 months, and symptom onset at least 12 months prior to the study) or dyspepsia symptom (based on Rome II criteria). The frequency of health resource utilization (i.e. physician visit, hospitalization, laboratory tests, instrumental studies, and medications) and productivity loss (days off work) due to gastro-oesophageal reflux disease/dyspepsia-related symptoms in the past 12 months were recorded. Societal perspective was used, and cost of illness per person per year was estimated in purchasing power parity dollars (PPP$).ResultsThe cost of illness per person per year for patients with gastro-oesophageal reflux disease, and dyspepsia alone were around PPP$195 and PPP$215, respectively. There was no statistically significant difference in the cost of illness between the two patient groups. The direct costs of disease comprised 88%, and 82% of the total costs in gastro-oesophageal reflux disease and dyspepsia patients, respectively with the costs of medications being the dominant component. There was also no statistically significant difference in the cost of disease between the gastro-oesophageal reflux disease patients with and without oesophagitis (based on Los Angeles criteria).ConclusionAs drugs cost was found to be a dominant cost component, cost-minimization studies to find the best medication therapy strategies considering the regional factors is suggested.