Gastric Alimetry® Testing and Healthcare Economic Analysis in Nausea and Vomiting Syndromes

• Published in: Digestive diseases and sciences 2024-07, Vol.69 (7), p.2304-2314
• Main Authors: Xu, William, Williams, Lucy, Sebaratnam, Gabrielle, Varghese, Chris, Cedarwall, Chris, Daker, Charlotte, Keane, Celia
• Format: Article
• Language: English
• Subjects: Adult; Biochemistry; Cost control; Cost-Benefit Analysis; Decision Trees; Dyspepsia - diagnosis; Dyspepsia - economics; Female; Gastroenterology; Gastroparesis - diagnosis; Gastroparesis - economics; Health Care Costs - statistics & numerical data; Health services utilization; Hepatology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nausea; Nausea - diagnosis; Nausea - economics; Nausea - etiology; New Zealand; Oncology; Original Article; Transplant Surgery; Vomiting; Vomiting - diagnosis; Vomiting - economics; Young Adult
• ISSN: 0163-2116; 1573-2568; 1573-2568
• DOI: 10.1007/s10620-024-08455-0

Background Chronic nausea and vomiting syndromes (CNVS), gastroparesis and functional dyspepsia (FD) are complex disorders. Body Surface Gastric Mapping (BSGM), a new test of gastric function, using Gastric Alimetry® (Alimetry, New Zealand) may be useful for de-escalating healthcare utilisation. This study aimed to define healthcare costs and estimate health economic impacts of implementing this test in patients with chronic gastroduodenal symptoms. Methods Consecutive patients at a tertiary referral centre evaluated with Gastric Alimetry were included. Frequency and cost data relating to medical investigations, hospital and outpatient presentations were evaluated. Costs of healthcare utilisation were calculated, and the potential cost savings of implementing Gastric Alimetry within a diagnostic decision-tree model were estimated. Results Overall, 31 consecutive patients (mean age 36.1 years; 83.9% female; predominant symptoms: nausea [83.9%], pain [61.3%], vomiting [67.7%] and bloating [35.5%]) completed Gastric Alimetry testing. Repeat gastroscopy and abdominal CT rates were 29% (8/28) and 85% (11/13), respectively. Gastric Alimetry testing identified spectral abnormalities in 45.2% of patients, and symptom profiling classified a further 29.1% of patients. Median annualised cost difference after test introduction was NZ$-12,032. Estimated reductions in investigation-related costs when incorporating Gastric Alimetry into the diagnostic workflow model were approximately NZ$1,300 per patient. Conclusions Healthcare utilisation and confirmatory testing rates remain high in nausea and vomiting syndromes. This study presents real-world data, together with a decision-tree analysis, showing Gastric Alimetry can streamline clinical care pathways, resulting in reduced healthcare utilisation and cost.