Pneumatic Dilation: The Most Cost-Effective Treatment for Achalasia

Pneumatic dilation is the most cost-effective treatment option for achalasia in most clinical situations, although the best strategy should consider both risks and benefits of each approach.

Treatment options for achalasia include pharmacologic therapy, botulinum toxin type A (Botox) injection, pneumatic balloon dilation, and surgical myotomy. Although all approaches have had some reported success, pharmacologic therapy provides only short-term symptomatic relief and, therefore, is not viewed as a realistic option. Researchers constructed a Markov model to evaluate the cost-effectiveness of the other 3 treatment strategies for achalasia. Costs and probabilities were derived from published literature.

The model was based on a typical 50-year-old patient with newly diagnosed achalasia who was eligible for all 3 treatments. For the botulinum toxin treatment, 25 units of Botox were injected into each of the 4 quadrants of the lower …

Reviewing Author

David A. Johnson, MD