The Pharmacoeconomics of Proton Pump Inhibitors Prescribing in Ireland
Keywords:
medicineAbstract
Objectives: The purpose of this study was to determine cost-saving measures in the
treatment of patients with conditions requiring proton pump inhibitor (PPI) maintenance
therapy, and to examine factors that contribute to inappropriate PPI prescribing.
Methods: Cost-Minimisation Analysis was used as the method of pharmacoeconomic
evaluation for this study, an appropriate method given the National Institute for Clinical
Excellence guidelines from July 2000, which concluded that all five PPIs on the market
have equal efficacy. Results: Despite its higher cost, the original PPI omeprazole
(Losec®) is still the most frequently prescribed PPI. In PPI maintenance therapy,
substitution with any generic form of omeprazole (Losamel, Ulcid, Lopraz, or Losepine)
is more cost-effective than using the brand-name omeprazole. Furthermore, in
prescribing maintenance therapy for specific indications such as GORD, duodenal ulcer,
and NSAID-induced peptic ulcer, rabeprazole (Pariet), lansoprazole (Zoton), or
pantoprazole (Protium), respectively, are more cost-effective options compared with
brand-name omeprazole. Conclusion: Substitution with these PPIs would be expected to
produce savings of over six million euro per year.
References
2003;65:103-31.
2. Hersey SJ, Sachs G. Gastric Acid Secretion. Physiol Rev 1995;75:155-89.
3. Robinson, M. Review article: the pharmacodynamics and pharmacokinetics of proton
pump inhibitors – overview and clinical implications. Aliment Pharmacol Ther 2004; 20
(Suppl. 6):1-10.
4. Cabero JL, Grapengiesser E, Gylfe E, Li ZQ, Mardh S. Effects of Gastrin on Cytosolic
Free Ca2+ in Individual, Acid-Secreting Rat Parietal Cells. Biochem Biophys Res Commu
1992;183:1097-1102.
5. Hill SJ. Histamine Receptors and Interactions between Second Messenger
Transduction Systems. Agents Actions Suppl 1991; 33:145-59.
6. Forte JG, Yao X. The Membrane-Recruitment-and-Recycling Hypothesis of Gastric
HCL Secretion. Trends Cell Biol. 1996;6(2):45-48.
7. Okamoto CT, Forte JG. Vesicular Trafficking Machinery, the Actin Cytoskeletion, and
H
+
/K+ ATPase Recycling in the Gastric Parietal Cell. J Physio. 2001; 532: 287-96.
8. Forte TM, Machen TE, Forte JG. Ultrastructural Changes in Oxyntic Cells Associated
with Secretory Function: A Membrane Recycling Hypothesis. Gastroenterology. 1977;
73:941-55.
9. Ito S. Functional Gastric Morphology Physiology of the Gastrointestinal Tract, ed. pp.
817-51. New York: Raven. DATE
10. Helander HF. The Cells of the Gastric Mucosa. Int. Rev. Cytol. 1981; 70:217-89.
11. Kromer W, Kruger U, Huber R, Hartmann M, Steinijans VW. Differences in pHdependent Activation Rates of Substituted Benimidazoles and Biological in vitro
Correlates. Pharmacology. 1998;56(2):57-70.
12. Mycek MJ, Harvey RA, Champe PC, Lippincott‟s Illustrated Reviews:
Pharmacology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2000:239
13. Sachs G, Shin JM, Munson K. et al. Review Article : The Control of Gastric Acid and
Helicobacter pylori Eradication. Aliment. Pramacol. Ther. 2000; 14(11): 1383-1401.
14. Penston JG, Pounder RE. A survey of dyspepsia in Great Britain. Aliment Pharmacol
Ther 1996;10:83-89
15. Bradhan KD, Cherian P, Vaishnavi A. et al. Erosive oesophagitis: outcome of
repeated long term maintenance treatment with low dose omeprazole 10mg or placebo.
Gut 1998;43:458-64.
16. General Medical Services Payments Board. Reports for the years ending 31st
December 2000-2004. PUBLISHED BY WHO?
17. British Medical Association and Royal Pharmaceutical Society of Great Britain.
British National Formulary ed. BMJ Publishing Group London, 2005: PAGE AND
EDITION
18. National Centre for Clinical Excellence. Guidance on the use of Proton Pump
Inhibitors (PPI) in the Treatment of Dyspepsia. 2000. Available from: URL
http://www.nice.org.uk/page.aspx?o=3109
19. Walley T, Haycox A. Pharmacoeconomics: basic concepts and terminology.
Br J Clin Pharmacol. 1997;43:343-48.
20. Barry M, Feely J. Pharmacoeconomics in Ireland - concepts and terminology. Ir J
Med Sci 2000;169(1):63-64.
21. MIMS. Medical Publications (Ireland) Ltd. September 2003
22. The Pharmaceutical Society of Ireland. Council statement on the use of generic
medications in pharmaceutical practice. Available from:
http://www.pharmaceuticalsociety.ie/news/archived_news/generic_medicines.html
23. Raghunath AS, Hungin APS, Cornford CS, Featherstone V. Use of proton pump
inhibitors: an exploration of the attitudes, knowledge and perceptions of general
practitioners. Digestion. 2005; 72: 212-218.
Downloads
Published
How to Cite
Issue
Section
License
Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.
Provided they are the owners of the copyright to their work, authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work (e.g., post it to an institutional repository, in a journal or publish it in a book), with an acknowledgement of its initial publication in this journal.
