Open Access Open Badges Research article

Cost and burden of gastroesophageal reflux disease among patients with persistent symptoms despite proton pump inhibitor therapy: an observational study in France

Stanislas Bruley des Varannes1*, Helena Granstedt Löfman2, Maria Karlsson2, Peter Wahlqvist2, Magnus Ruth2, Mary Lou Furstnau3, Nicolas Despiégel3 and Nils-Olov Stålhammar2

Author Affiliations

1 Institut des Maladies de l’Appareil Digestif, University Hospital – CHU Hôtel Dieu, Place A Ricordeau, Nantes Cedex, 44093, France

2 AstraZeneca R&D, Mölndal, Sweden

3 OptumInsight, Nanterre, France

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BMC Gastroenterology 2013, 13:39  doi:10.1186/1471-230X-13-39

Published: 28 February 2013



Gastrointestinal reflux disease (GERD) is a common disorder that negatively impacts health-related quality of life (HRQL) and work productivity. Many patients have only a partial response to proton pump inhibitor (PPI) therapy and continue to experience GERD symptoms despite optimized treatment. This observational study aimed to provide information on symptoms, HRQL, resource usage, costs and treatment pathways associated with partial response to PPI therapy in French patients with GERD.


Patients with partial response to PPI therapy, defined as persistent GERD symptoms ≥3 days/week despite optimized treatment with a PPI, were recruited for this 12-month observational study. GERD symptoms, HRQL, work productivity and resource use were assessed by patient surveys. Costs were calculated based on lost work productivity and resource use.


The patient population (n=262; mean age, 54 years; 40% men) carried a significant symptom burden, with 98% of patients having moderate-to-severe GERD symptoms and 65% of patients experiencing daily symptoms at baseline. HRQL and work productivity were significantly impaired, with a greater degree of impairment in patients with higher symptom burden. The mean total cost per patient over the 12-month follow-up period was €5237, of which €4674 (89%) was due to lost work productivity.


Partial response to PPI therapy for GERD is associated with a high symptom burden, significant impairment of HRQL and work productivity, and substantial GERD-related costs.

PPIs; GERD; Quality of life; Productivity