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. 2022 Jul 15;10(7):E923–E932. doi: 10.1055/a-1783-9378

Table 1. Markov model inputs: medical versus endoscopic versus surgical therapies for refractory GERD.

Probabilities Estimates Range (95 % CI) Distribution Supplemental references
Survive TIF procedure 0.999 0.990 to 1.000 Beta 1
Survive LNF procedure 0.992 0.985 to 1.000 Beta 2–5
Initial success rate, TIF 0.990 0.970 to 1.000 Beta 6
Initial success rate, LNF 0.990 0.970 to 1.000 Beta 3, 7, 8
Adverse event rate, TIF 0.020 0.010 to 0.030 Beta 6
Adverse event rate, LNF 0.061 0.013 to 0.101 Beta 5, 9, 10
Immediate PPI discontinuation rate, TIF 0.890 0.820 to 0.950 Beta 6
Immediate PPI discontinuation rate, LNF 0.933 0.869 to 0.995 Beta 10, 11
1-year PPI discontinuation rate, TIF 0.783 0.760 to 0.890 Beta 6, 12
1-year PPI discontinuation rate, LNF 0.810 0.743 to 0.864 Beta 13, 14
2-year PPI discontinuation rate, TIF 0.764 0.710 to 0.770 Beta 12, 15, 16
2-year PPI discontinuation rate, LNF 0.760 0.706 to 0.805 Beta 17
3-year PPI discontinuation rate, TIF 0.712 0.650 to 0.751 Beta 12, 16
3-year PPI discontinuation rate, LNF 0.690 0.635 to 0.770 Beta 13, 18
5-year PPI discontinuation rate, TIF 0.540 0.412 to 0.600 Beta 19, 20
5-year PPI discontinuation rate, LNF 0.706 0.690 to 0.722 Beta 21
10-year PPI discontinuation rate, TIF 0.417 0.330 to 0.510 Beta 20, 22
10-year PPI discontinuation rate, LNF 0.589 0.570 to 0.608 Beta 21
Costs (US $, 2019)

  • Baseline endoscopy

 $ 761.00 $ 570.75 to $ 951.25 Gamma 23

  • Barium esophagram

 $ 230.00 $ 172.50 to $ 287.50 Gamma 23

  • Esophageal manometry/pH impedance

 $ 588.00 $ 441.00 to $ 697.50 Gamma 23

  • Omeprazole 20 mg (per pill)

 $ 1.54 $ 0.39 to $ 1.93 Gamma 24

  • Omeprazole 40 mg (per pill) 1

$ 4.39 $ 1.10 to $ 5.49 Gamma 24

  • TIF procedure (professional claims)

 $ 2410.51 $ 2035.65 to $ 2785.38 Gamma 25

  • TIF procedure (facility claims)

 $ 7314.62 $ 6950.25 to $ 9499.96 Gamma 25

  • LNF procedure (professional claims)

 $ 3078.45 $ 2955.08 to $ 3201.82 Gamma 25

  • LNF procedure (facility claims)

 $ 10393.11 $ 12429.99 to $ 13832.44 Gamma 25

  • Adverse events

 $ 5177.00 $ 3882.75 to $ 6471.25 Gamma 23, 26
Utilities (health states)

  • Refractory GERD on PPI

 0.885 0.770 to 0.940 Triangular 3, 27, 28

  • Well-controlled GERD on PPI

 0.998 0.980 to 1.000 Triangular 3, 29, 30

  • Resolved GERD off PPI

 1.000 – – –

  • Death

 0.000 – – –

  • Post-TIF procedure (2 weeks)

 0.600 0.450 to 0.750 Triangular 3

  • Post-LNF procedure (2 weeks)

 0.500 0. 400 to 0.700 Triangular 3, 30

  • Dysphagia (2 weeks)

 0.620 0. 550 to 0.800 Triangular 3, 30

  • Esophageal or gastric ulceration (2 weeks)

 0.620 0.500 to 0.750 Triangular 3, 30

GERD, gastroesophageal reflux disease; TIF, transoral incisionless fundoplication; LNF, laparoscopic Nissen fundoplication; CI, confidence interval; PPI, proton pump inhibitor.

1

Alternative PPI costs shown in Supplementary Material.