Costs of pharmacotherapy for gastroesophageal reflux disease in obese patients depending on the bariatric surgery method

Despite significant weight loss after bariatric surgery, some patients may develop gastroesophageal reflux disease (GERD) or experience its exacerbation if it existed prior to the surgery. The impact of different bariatric procedures on reflux has been studied in several scientific works, but no universally accepted approach to selecting surgical techniques considering GERD currently exists. The diverse clinical and diagnostic manifestations of GERD complicate its classification. The severity of reflux can be quantified by pharmacotherapy costs, including those for proton pump inhibitors (PPIs). Objective. The objective of this study was to analyze changes in pharmacotherapy costs in patients with GERD diagnosed before bariatric surgery for morbid obesity, depending on the type of surgical procedure performed. Materials and methods. Data were analyzed from 70 patients who received PPIs for GERD before surgery. Changes in pharmacotherapy costs were assessed for two types of bariatric surgery: sleeve gastrectomy (SG) in 32 patients and Roux-en-Y gastric bypass (RYGB) in 38 patients. Results. In the SG group, the median pharmacotherapy cost over six months before surgery was 4944 rubles, decreasing to 1807 rubles 18–24 months post-surgery (p=0.00076). In the RYGB group, costs decreased from 3803 rubles pre-surgery to 533 rubles post-surgery (p < 0.00001). Conclusion. The reduction in GERD therapy costs after SG suggests a positive effect of weight loss and obesity treatment on GERD. However, SG may sometimes lead to significant reflux exacerbation. A more pronounced anti-reflux effect, reflected in a greater reduction in pharmacotherapy costs, was observed in the RYGB group, making this procedure the preferred option for patients with both morbid obesity and GERD.