PMID- 15369428
OWN - NLM
STAT- MEDLINE
DCOM- 20041026
LR  - 20230823
IS  - 1083-4087 (Print)
IS  - 1944-706X (Electronic)
IS  - 1083-4087 (Linking)
VI  - 10
IP  - 5
DP  - 2004 Sep-Oct
TI  - Effects on the cost and utilization of proton pump inhibitors from adding 
      over-the counter omeprazole to drug benefit coverage in a state employee health 
      plan.
PG  - 449-55
LID - 10.18553/jmcp.2004.10.5.449
AB  - OBJECTIVE: To evaluate the financial effects in a state employee health plan of a 
      change in the drug coverage policy to include over-the-counter (OTC) omeprazole 
      in a tier-copayment drug benefit design that favored the OTC drug. METHODS: The 
      policy change in the Arkansas State Employee Benefit Division (EBD) involved 2 
      principal parts: OTC omeprazole placed in a new OTC copayment tier (5 dollars) 
      and an increase in pharmacy reimbursement to a 13 dollars dispensing fee for each 
      OTC omeprazole prescription. The prescription claims database was used to examine 
      utilization and cost data for beneficiaries who received prescriptions for a 
      proton pump inhibitor (PPI) during the 2-month period (January and February 2004) 
      preceding the change in policy to cover OTC omeprazole compared with the 2-month 
      period following the policy change (March and April 2004). RESULTS: During the 
      first week of the new policy (March 1-7, 2004), OTC omeprazole accounted for 47% 
      of all PPI claims. From the third week through the end of the 2-month study 
      period, OTC omeprazole represented 60% of PPI claims. This shift to OTC 
      omeprazole from prescription PPIs produced EBD average savings of 40.86 dollars 
      (40.5%) per PPI claim in the first 2 months after implementation of coverage of 
      OTC omeprazole compared with the immediate previous 2-month period. The average 
      copayment savings for EBD beneficiaries were 4.20 dollars (16.5%) per PPI claim. 
      The average increase in pharmacy reimbursement was 118% (6.27 dollars per claim 
      in the postperiod versus 2.88 dollars per claim in the preperiod). Despite a 
      17.2% increase in utilization as measured by days of PPI therapy per member per 
      month (1.91 PMPM) in the postperiod versus 1.63 in the preperiod, EBD savings 
      were 2.11 dollars (38.9%) PMPM. Based upon PMPM savings of 2.56 dollars in the 
      second month of coverage of OTC omeprazole, annual savings would be about 
      3,978,240 dollars for average eligible membership of 129,500 in this state 
      employee health plan. CONCLUSION: This policy change to include coverage of OTC 
      omeprazole in the state employee drug benefit plan produced savings to the state 
      of as much as 50% of the total cost of PPI drugs despite an apparent small 
      increase in utilization of PPIs and an increase in pharmacy reimbursement of more 
      than 100%. Plan beneficiaries realized significant savings on average for PPI 
      drugs and particularly for each OTC omeprazole prescription.
FAU - Harris, Brittany N
AU  - Harris BN
AD  - University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, 
      Arkansas 72205-7199, USA. bnharris@uams.edu
FAU - West, Donna S
AU  - West DS
FAU - Johnson, Jill
AU  - Johnson J
FAU - Hong, Song Hee
AU  - Hong SH
FAU - Stowe, Cindy D
AU  - Stowe CD
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Manag Care Pharm
JT  - Journal of managed care pharmacy : JMCP
JID - 9605854
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Drugs, Generic)
RN  - 0 (Nonprescription Drugs)
RN  - 0 (Proton Pump Inhibitors)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
EIN - J Manag Care Pharm. 2005 Jan-Feb;11(1):87
CIN - J Manag Care Pharm. 2004 Sep-Oct;10(5):458-60. PMID: 15369431
MH  - Anti-Ulcer Agents/*economics/therapeutic use
MH  - Arkansas
MH  - *Costs and Cost Analysis
MH  - Databases, Factual
MH  - Drugs, Generic/*economics
MH  - Health Benefit Plans, Employee/*economics/statistics & numerical data
MH  - Humans
MH  - Insurance, Pharmaceutical Services/*economics
MH  - Nonprescription Drugs/*economics/therapeutic use
MH  - Omeprazole/*economics/therapeutic use
MH  - *Proton Pump Inhibitors
PMC - PMC10437838
EDAT- 2004/09/17 05:00
MHDA- 2004/10/27 09:00
PMCR- 2004/09/01
CRDT- 2004/09/17 05:00
PHST- 2004/09/17 05:00 [pubmed]
PHST- 2004/10/27 09:00 [medline]
PHST- 2004/09/17 05:00 [entrez]
PHST- 2004/09/01 00:00 [pmc-release]
AID - 2004(10)5: 449-455 [pii]
AID - 10.18553/jmcp.2004.10.5.449 [doi]
PST - ppublish
SO  - J Manag Care Pharm. 2004 Sep-Oct;10(5):449-55. doi: 10.18553/jmcp.2004.10.5.449.