Proton pump inhibitors: potential cost reductions by applying prescribing guidelines

Area of Science:

• Pharmacoeconomics
• Health Services Research
• Gastroenterology

Background:

• Concerns exist regarding the over-prescription of proton pump inhibitors (PPIs) in healthcare settings.
• This study investigates potential cost savings associated with PPI prescribing within a community drug scheme.

Purpose of the Study:

• To estimate the potential cost savings achievable over one year by optimizing proton pump inhibitor (PPI) prescribing.
• To evaluate savings based on established clinical and cost-effectiveness guidelines.

Main Methods:

• A retrospective, population-based cohort study utilized pharmacy claims data from the Irish Health Services Executive (HSE) Primary Care Reimbursement Services (PCRS).
• Analysis included 167,747 claimants on PPI therapy for at least three consecutive months in 2007.
• Five cost-saving scenarios were modeled, including generic substitution, dose reduction, and switching to H2 antagonists.

Main Results:

• The total net ingredient cost for PPI therapy in 2007 was over €88 million.
• Estimated one-year savings ranged from €21 million (24% reduction) for dose reduction to €40 million (46% reduction) for combined therapeutic switching and dose reduction.

Conclusions:

• Substantial cost savings are achievable through the national implementation of clinical guidelines for PPI prescribing.
• Strategies such as generic substitution and step-down therapy present significant opportunities for cost reduction in pharmaceutical spending.