IQoro for hiatus hernia

The technology described in this briefing is IQoro. It is a neuromuscular training device used for improving symptoms related to hiatus hernia by strengthening the oesophagus and diaphragm. It is initially used daily for 3 to 6 months, with follow up maintenance use dependent upon individual need.

The innovative aspects are that IQoro is the only device available for treating hiatus hernia with oral, neuromuscular training and an exercise regime.

The intended place in therapy would be as an alternative to long-term proton pump inhibitor (PPI) treatment or laparascopic fundoplication surgery in people with hiatus hernia.

The main points from the evidence summarised in this briefing are from 3 non-comparative, observational studies including 148 adults in Swedish ear, nose and throat clinics. They show that IQoro may improve symptoms related to hiatus hernia when used for 6 to 8 months in people with long-term hiatus hernia.

Key uncertainties around the evidence are that it is limited in quantity and quality. The effect of IQoro may be overestimated because of a lack of a control group. A study comparing IQoro with standard NHS care would help address this.

The cost of IQoro is £116 per unit (exclusive of VAT). The resource impact would be greater than standard care, but costs may be offset by reducing long-term PPI maintenance.