New Barrett's oesophagus surveillance guidelines: significant cost savings over the next 10 years on implementation.

OBJECTIVE

We aimed to estimate the cost saving (over the next 10 years) by our trust implementing the new British Society of Gastroenterology (BSG) surveillance guidelines for Barrett's oesophagus (BO).

DESIGN

Retrospective endoscopy database analysis.

SETTING

Two endoscopy units of St George's Hospital NHS Trust, London.

PATIENTS: Gastroscopy records between 2009 and 2012 were retrieved and patients with an endoscopic diagnosis of BO were identified. BO segment length was recorded and the presence (or absence) of intestinal metaplasia in the oesophageal biopsy samples was reviewed from pathology databases. Patients were then stratified into risk groups in accordance with the new BSG guidelines.

INTERVENTIONS: Nil.

MAIN OUTCOME MEASURES: The projected surveillance costs using the new and the old guidelines were calculated over the next 10 years and the cost saving by the implementation of the new guidelines thus determined.

RESULTS

The 10 year projected cost saving for our trust by implementing the new BO surveillance guidelines was £720 330 (or £72 033 per annum). Projected across the NHS, implementation of the new guidance may save £100 million over the next 10 years.

CONCLUSIONS

All trusts should review their Barrett's surveillance population and implement these new recommendations expeditiously.