Cost-Effectiveness Analysis of Vonoprazan Vs PPIs in the Treatment of Gastroesophageal Reflux Disease

Abstract

Introduction: Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder characterized by the reflux of gastric contents into the esophagus, leading to symptoms such as heartburn and regurgitation. Proton pump inhibitors (PPIs) are the standard therapy, while vonoprazan, a potassium-competitive acid blocker, is a newer alternative with improved acid suppression. Objective: To evaluate and compare the cost-effectiveness of vonoprazan and PPIs in the treatment of GERD. Methodology: A multicentric, prospective, observational, and comparative study was conducted over a period of 3 months. A total of 100 patients were enrolled and equally divided into two groups: vonoprazan (n=50) and PPIs (n=50). Data were collected through patient interviews, case records, and validated scales such as the Frequency Scale for the Symptoms of GERD (FSSG) and Morisky Medication Adherence Scale (MMAS-8). Cost-effectiveness was assessed using the average cost-effectiveness ratio (CER). Results and Discussion: Male predominance was observed in both groups, and the majority of patients belonged to the middle age group. Both treatment groups showed significant improvement in GERD symptoms, as indicated by reduction in FSSG scores, with comparatively greater improvement observed in the vonoprazan group. The mean cost-effectiveness ratio (CER) was higher in the vonoprazan group (67.80 ± 27.76) compared to the PPIs group (62.09 ± 31.61), indicating relatively better cost-effectiveness of PPIs. These findings are consistent with previous studies. Conclusion: Both vonoprazan and PPIs are effective in the management of GERD. Vonoprazan provides better symptom improvement, while PPIs remain a more cost-effective option. Therefore, PPIs can be considered a preferred economical treatment, especially in resource-limited settings.