Proton pump inhibitors: potential cost reductions by applying prescribing guidelines.

Hdl Handle:
http://hdl.handle.net/10147/302393
Title:
Proton pump inhibitors: potential cost reductions by applying prescribing guidelines.
Authors:
Cahir, Caitriona; Fahey, Tom; Tilson, Lesley; Teljeur, Conor; Bennett, Kathleen
Affiliation:
HRB Centre for Primary Care Research, Division of Population Health Science, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland. caitrionacahir@rcsi.ie
Citation:
Proton pump inhibitors: potential cost reductions by applying prescribing guidelines. 2012, 12:408 BMC Health Serv Res
Journal:
BMC health services research
Issue Date:
2012
URI:
http://hdl.handle.net/10147/302393
DOI:
10.1186/1472-6963-12-408
PubMed ID:
23163956
Additional Links:
http://www.biomedcentral.com/content/pdf/1472-6963-12-408.pdf
Abstract:
There are concerns that proton pump inhibitors (PPI) are being over prescribed in both primary and secondary care. This study aims to establish potential cost savings in a community drug scheme for a one year period according to published clinical and cost-effective guidelines for PPI prescribing.; Retrospective population-based cohort study in the Republic of Ireland using the Health Services Executive (HSE) Primary Care Reimbursement Services (PCRS) pharmacy claims database. The HSE-PCRS scheme is means tested and provides free health care including medications to approximately 30% of the Irish population. Prescription items are WHO ATC coded and details of every drug dispensed and claimants' demographic data are available. Potential cost savings (net ingredient cost) were estimated according to UK NICE clinical guidelines for all HSE-PCRS claimants on PPI therapy for ≥3 consecutive months starting in 2007 with a one year follow up (n=167,747). Five scenarios were evaluated; (i) change to PPI initiation (cheapest brand); and after 3 months (ii) therapeutic switching (cheaper brand/generic equivalent); (iii) dose reduction (maintenance therapy); (iv) therapeutic switching and dose reduction and (v) therapeutic substitution (H2 antagonist).; Total net ingredient cost was €88,153,174 for claimants on PPI therapy during 2007. The estimated costing savings for each of the five scenarios in a one year period were: (i) €36,943,348 (42% reduction); (ii) €29,568,475 (34%); (iii) €21,289,322 (24%); (iv) €40,505,013 (46%); (v) €34,991,569 (40%).; There are opportunities for substantial cost savings in relation to PPI prescribing if implementation of clinical guidelines in terms of generic substitution and step-down therapy is implemented on a national basis.
Item Type:
Article
Language:
en
Description:
Background: There are concerns that proton pump inhibitors (PPI) are being over prescribed in both primary and secondary care. This study aims to establish potential cost savings in a community drug scheme for a one year period according to published clinical and cost-effective guidelines for PPI prescribing. Methods: Retrospective population-based cohort study in the Republic of Ireland using the Health Services Executive (HSE) Primary Care Reimbursement Services (PCRS) pharmacy claims database. The HSE-PCRS scheme is means tested and provides free health care including medications to approximately 30% of the Irish population. Prescription items are WHO ATC coded and details of every drug dispensed and claimants’ demographic data are available. Potential cost savings (net ingredient cost) were estimated according to UK NICE clinical guidelines for all HSE-PCRS claimants on PPI therapy for ≥3 consecutive months starting in 2007 with a one year follow up (n=167,747). Five scenarios were evaluated; (i) change to PPI initiation (cheapest brand); and after 3 months (ii) therapeutic switching (cheaper brand/generic equivalent); (iii) dose reduction (maintenance therapy); (iv) therapeutic switching and dose reduction and (v) therapeutic substitution (H2 antagonist). Results: Total net ingredient cost was €88,153,174 for claimants on PPI therapy during 2007. The estimated costing savings for each of the five scenarios in a one year period were: (i) €36,943,348 (42% reduction); (ii) €29,568,475 (34%); (iii) €21,289,322 (24%); (iv) €40,505,013 (46%); (v) €34,991,569 (40%).
MeSH:
Adolescent; Adult; Aged; Cost Savings; Databases, Factual; Drug Costs; Drug Substitution; Female; Humans; Ireland; Male; Middle Aged; Physician's Practice Patterns; Practice Guidelines as Topic; Proton Pump Inhibitors; Retrospective Studies; Young Adult
ISSN:
1472-6963

Full metadata record

DC FieldValue Language
dc.contributor.authorCahir, Caitrionaen_GB
dc.contributor.authorFahey, Tomen_GB
dc.contributor.authorTilson, Lesleyen_GB
dc.contributor.authorTeljeur, Conoren_GB
dc.contributor.authorBennett, Kathleenen_GB
dc.date.accessioned2013-09-27T10:50:19Z-
dc.date.available2013-09-27T10:50:19Z-
dc.date.issued2012-
dc.identifier.citationProton pump inhibitors: potential cost reductions by applying prescribing guidelines. 2012, 12:408 BMC Health Serv Resen_GB
dc.identifier.issn1472-6963-
dc.identifier.pmid23163956-
dc.identifier.doi10.1186/1472-6963-12-408-
dc.identifier.urihttp://hdl.handle.net/10147/302393-
dc.descriptionBackground: There are concerns that proton pump inhibitors (PPI) are being over prescribed in both primary and secondary care. This study aims to establish potential cost savings in a community drug scheme for a one year period according to published clinical and cost-effective guidelines for PPI prescribing. Methods: Retrospective population-based cohort study in the Republic of Ireland using the Health Services Executive (HSE) Primary Care Reimbursement Services (PCRS) pharmacy claims database. The HSE-PCRS scheme is means tested and provides free health care including medications to approximately 30% of the Irish population. Prescription items are WHO ATC coded and details of every drug dispensed and claimants’ demographic data are available. Potential cost savings (net ingredient cost) were estimated according to UK NICE clinical guidelines for all HSE-PCRS claimants on PPI therapy for ≥3 consecutive months starting in 2007 with a one year follow up (n=167,747). Five scenarios were evaluated; (i) change to PPI initiation (cheapest brand); and after 3 months (ii) therapeutic switching (cheaper brand/generic equivalent); (iii) dose reduction (maintenance therapy); (iv) therapeutic switching and dose reduction and (v) therapeutic substitution (H2 antagonist). Results: Total net ingredient cost was €88,153,174 for claimants on PPI therapy during 2007. The estimated costing savings for each of the five scenarios in a one year period were: (i) €36,943,348 (42% reduction); (ii) €29,568,475 (34%); (iii) €21,289,322 (24%); (iv) €40,505,013 (46%); (v) €34,991,569 (40%).en_GB
dc.description.abstractThere are concerns that proton pump inhibitors (PPI) are being over prescribed in both primary and secondary care. This study aims to establish potential cost savings in a community drug scheme for a one year period according to published clinical and cost-effective guidelines for PPI prescribing.-
dc.description.abstractRetrospective population-based cohort study in the Republic of Ireland using the Health Services Executive (HSE) Primary Care Reimbursement Services (PCRS) pharmacy claims database. The HSE-PCRS scheme is means tested and provides free health care including medications to approximately 30% of the Irish population. Prescription items are WHO ATC coded and details of every drug dispensed and claimants' demographic data are available. Potential cost savings (net ingredient cost) were estimated according to UK NICE clinical guidelines for all HSE-PCRS claimants on PPI therapy for ≥3 consecutive months starting in 2007 with a one year follow up (n=167,747). Five scenarios were evaluated; (i) change to PPI initiation (cheapest brand); and after 3 months (ii) therapeutic switching (cheaper brand/generic equivalent); (iii) dose reduction (maintenance therapy); (iv) therapeutic switching and dose reduction and (v) therapeutic substitution (H2 antagonist).-
dc.description.abstractTotal net ingredient cost was €88,153,174 for claimants on PPI therapy during 2007. The estimated costing savings for each of the five scenarios in a one year period were: (i) €36,943,348 (42% reduction); (ii) €29,568,475 (34%); (iii) €21,289,322 (24%); (iv) €40,505,013 (46%); (v) €34,991,569 (40%).-
dc.description.abstractThere are opportunities for substantial cost savings in relation to PPI prescribing if implementation of clinical guidelines in terms of generic substitution and step-down therapy is implemented on a national basis.-
dc.language.isoenen
dc.relation.urlhttp://www.biomedcentral.com/content/pdf/1472-6963-12-408.pdfen_GB
dc.rightsArchived with thanks to BMC health services researchen_GB
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshCost Savings-
dc.subject.meshDatabases, Factual-
dc.subject.meshDrug Costs-
dc.subject.meshDrug Substitution-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshIreland-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPhysician's Practice Patterns-
dc.subject.meshPractice Guidelines as Topic-
dc.subject.meshProton Pump Inhibitors-
dc.subject.meshRetrospective Studies-
dc.subject.meshYoung Adult-
dc.titleProton pump inhibitors: potential cost reductions by applying prescribing guidelines.en_GB
dc.typeArticleen
dc.contributor.departmentHRB Centre for Primary Care Research, Division of Population Health Science, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland. caitrionacahir@rcsi.ieen_GB
dc.identifier.journalBMC health services researchen_GB
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