PMID- 12181872
OWN - NLM
STAT- MEDLINE
DCOM- 20020925
LR  - 20131121
IS  - 1062-3388 (Print)
IS  - 1062-3388 (Linking)
VI  - 11
IP  - 7 Suppl
DP  - 2002 Jul
TI  - Impact of proton pump inhibitor utilization patterns on gastroesophageal reflux 
      disease-related costs.
PG  - 14-8
AB  - OBJECTIVE: To determine proton pump inhibitor (PPI) treatment patterns and their 
      effect on costs related to gastroesophageal reflux disease. METHODS: This study 
      used claims data to identify continuously enrolled subjects diagnosed with 
      gastroesophageal reflux disease (GERD) and newly treated with a PPI between Oct. 
      1, 1999 and March 31, 2000. Data were analyzed for 6 months following PPI 
      initiation. Results were stratified by first PPI filled during the study period. 
      Compliance (as measured by a medication-possession ratio), dosage escalation (> 
      25 percent of initial dose), and daily average consumption (DACON) were measured. 
      Regression analysis was performed on GERD-related costs using treatment patterns, 
      type of PPI drug, and compliance as independent variables of interest. RESULTS: 
      Of 75,452 subjects, there were 51,232 (67.9 percent) lansoprazole, 22,829 (30.3 
      percent) omeprazole, and 1,391 (1.8 percent) rabeprazole subjects. The possession 
      ratio was not significantly different by drug. Only 3.5 percent of rabeprazole 
      subjects escalated versus 5.5 percent of omeprazole subjects and 9.3 percent of 
      lansoprazole subjects (p = .0001). Among subjects with esophageal ulcer or hiatal 
      hernia, rabeprazole users had a significantly lower final DACON (1.03) versus 
      both lansoprazole (1.20) and omeprazole subjects (1.22, p = .0299). Subjects who 
      were compliant with therapy (ratio > 0.80) had 43 percent higher GERD-related 
      pharmacy costs and 33 percent higher GERD-related total costs (both p < .001). 
      GERD-related medical costs were not significantly affected by compliance. 
      Subjects who filled lansoprazole prescriptions had 9.4 percent higher 
      GERD-related pharmacy costs versus rabeprazole subjects (p < .01). Omeprazole 
      subjects had 12.5 percent higher GERD-related total costs versus rabeprazole 
      subjects (p < .01), while lansoprazole subjects had 18 percent higher 
      GERD-related total costs versus rabeprazole subjects (p < .001). CONCLUSIONS: 
      Rabeprazole subjects had lower GERD-related costs, less escalation, and lower 
      DACON (measured as number of tablets consumed per day), compared to lansoprazole 
      and omeprazole subjects. Compliance was not significantly different between the 
      drugs, nor did increased compliance decrease GERD-related costs.
FAU - Hall, Jennifer
AU  - Hall J
FAU - Dodd, Sheri
AU  - Dodd S
FAU - Durkin, Michael
AU  - Durkin M
FAU - Sloan, Sheldon
AU  - Sloan S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Manag Care
JT  - Managed care (Langhorne, Pa.)
JID - 9303583
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Benzimidazoles)
RN  - 0 (Enzyme Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0K5C5T2QPG (Lansoprazole)
RN  - 32828355LL (Rabeprazole)
RN  - KG60484QX9 (Omeprazole)
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Benzimidazoles/economics/*therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Drug Costs
MH  - Enzyme Inhibitors/economics/*therapeutic use
MH  - Female
MH  - Gastroesophageal Reflux/*drug therapy/*economics
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Lansoprazole
MH  - Male
MH  - Middle Aged
MH  - Omeprazole/*analogs & derivatives/economics/*therapeutic use
MH  - *Proton Pump Inhibitors
MH  - Rabeprazole
MH  - United States
EDAT- 2002/08/17 10:00
MHDA- 2002/09/26 06:00
CRDT- 2002/08/17 10:00
PHST- 2002/08/17 10:00 [pubmed]
PHST- 2002/09/26 06:00 [medline]
PHST- 2002/08/17 10:00 [entrez]
PST - ppublish
SO  - Manag Care. 2002 Jul;11(7 Suppl):14-8.