Proton pump inhibitors: potential cost reductions by applying prescribing guidelines.
AffiliationHRB Centre for Primary Care Research, Division of Population Health Science, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland. email@example.com
Physician's Practice Patterns
Practice Guidelines as Topic
Proton Pump Inhibitors
MetadataShow full item record
CitationProton pump inhibitors: potential cost reductions by applying prescribing guidelines. 2012, 12:408 BMC Health Serv Res
JournalBMC health services research
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.
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.
- Five-year examination of utilization and drug cost outcomes associated with benefit design changes including reference pricing for proton pump inhibitors in a state employee health plan.
- Authors: Johnson JT, Neill KK, Davis DA
- Issue date: 2011 Apr
- Potentially inappropriate prescribing and cost outcomes for older people: a national population study.
- Authors: Cahir C, Fahey T, Teeling M, Teljeur C, Feely J, Bennett K
- Issue date: 2010 May
- Characterizing Potentially Inappropriate Prescribing of Proton Pump Inhibitors in Older People in Primary Care in Ireland from 1997 to 2012.
- Authors: Moriarty F, Bennett K, Cahir C, Fahey T
- Issue date: 2016 Dec
- Proton pump inhibitor prescribing patterns in the UK: a primary care database study.
- Authors: Othman F, Card TR, Crooks CJ
- Issue date: 2016 Sep
- Analyzing generic and branded substitution patterns in the Netherlands using prescription data.
- Authors: Pechlivanoglou P, van der Veen WJ, Bos JH, Postma MJ
- Issue date: 2011 Apr 27