P1510 - Analysis of Cost and Value Statements of Advanced Endoscopy Guidelines from 2011-2023: A Scoping Review

Rahul Karna, MD¹, Amir Sultan Seid, MD², Himsikhar Khataniar, MD³, Ruchir Damjibhai. Paladiya, MBBS⁴, Muhammad Ali Butt, MD³, Jacquelin Blomker, MD², Azizullah Beran, MD⁵, Giovanni Roldan, MD², Susan M. Lou, MD⁶, Mohammad Bilal, MD^7
1University of Minnesota Medical Center, Minneapolis, MN; ²University of Minnesota, Minneapolis, MN; ³Allegheny General Hospital, Pittsburgh, PA; ⁴University of Connecticut Health Center, Hartford, CT; ⁵Indiana University School of Medicine, Indianapolis, IN; ⁶Minneapolis VAMC, Edina, MN; ⁷University of Minnesota and Minneapolis VA Health Care System, Minneapolis, MN

Introduction: In the last decade, there has been significant expansion in scope and limits of advanced endoscopic procedures. This expansion is accompanied with a parallel increase in procedure related health care costs. Gastroenterology professional societies have formulated clinical practice guidelines (CPG) to guide endoscopists in clinical decision making. There remains uncertainty regarding extent to which CPGs address the cost of therapy and overall values in these documents. We aim to conduct a scoping review of CPG pertaining to advanced endoscopic procedures by major GI organizations, the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), and the American Society for Gastrointestinal Endoscopy (ASGE) to describe the frequency and trends of cost and /or value (CV) statements.</span>

Methods: CPG and consensus documents put forward by the ACG, AGA and ASGE from 2011 to 2023 were collected. Guidelines related to pediatric populations were excluded. Statements from the guidelines were extracted on an excel sheet by two independents reviewers and analyzed to assess trends. Statements reporting on cost or value were further analyzed to assess, if they were used to report economic impact, advocate for cost incorporation, support a recommendation or highlight a gap in economic impact of recommendation. Statements used to support specific recommendations were further analyzed to assess their incorporation of patient level costs and society level costs.

Results: We included 42 CPGs (AGA:2, ACG: 5, ASGE: 35) pertaining to advanced endoscopy, reporting mean 2.35+/-2.13 statements per guideline related to cost or value to patients. The AGA reported highest number of statements per guideline (7), followed by ACG (3) and ASGE (2). Table 1 shows a comprehensive review of cost-value statements per guideline and their purpose in the CPG. Total of 62 CV statements justified CPG-specific recommendations, with 42(67.7%) focused on society level costs and 20 (32.2%) focused on individual-level cost value.

Discussion: With the increasing rates of advanced endoscopic procedures and the corresponding rise in healthcare costs, our analysis reveals a noteworthy lack of overall CV statements within CPG. There continues to be a gap in advocating for economic impact of treatment recommendations, and advocacy for more cost reports before making recommendations. Future guidelines should incorporate recommendations regarding healthcare costs and value, and impact on overall economy.



Disclosures:


Rahul Karna, MD¹, Amir Sultan Seid, MD², Himsikhar Khataniar, MD³, Ruchir Damjibhai. Paladiya, MBBS⁴, Muhammad Ali Butt, MD³, Jacquelin Blomker, MD², Azizullah Beran, MD⁵, Giovanni Roldan, MD², Susan M. Lou, MD⁶, Mohammad Bilal, MD⁷. P1510 - Analysis of Cost and Value Statements of Advanced Endoscopy Guidelines from 2011-2023: A Scoping Review, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.