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Related Experiment Videos

Concurrent use of antiulcerative agents

J Monette1, H Mogun, R L Bohn

  • 1Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Journal of Clinical Gastroenterology
|June 1, 1997
PubMed
Summary

Many physicians prescribe multiple antiulcerative agents (AUAs) without evidence, leading to significant excess costs. This study identified patient factors predicting concurrent AUA use and estimated substantial financial burdens.

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Area of Science:

  • Pharmacoeconomics
  • Gastroenterology
  • Health Services Research

Background:

  • Physicians frequently prescribe multiple antiulcerative agents (AUAs) concurrently.
  • Evidence supporting the efficacy of using more than one AUA simultaneously is limited.
  • This practice may lead to unnecessary costs and potential side effects.

Purpose of the Study:

  • To identify patient characteristics associated with concurrent AUA use.
  • To estimate the additional healthcare expenditures resulting from prescribing multiple AUAs instead of a single agent.

Main Methods:

  • A case-control study was conducted using New Jersey Medicaid enrollees aged 65 years and older.
  • Concurrent AUA use was defined conservatively.
  • Logistic regression analysis identified predictors of concurrent AUA use.

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  • Additional drug expenditures were measured to assess excess costs.

    • Main Results:

    • Approximately 6.6% of AUA users were prescribed multiple agents concurrently.
    • Predictors of concurrent AUA use included prior gastrointestinal procedures, NSAID use, nursing home residency, and prolonged hospitalization.
    • No association was found with age, sex, or number of pharmacies used.
    • The estimated excess cost per patient for a second AUA ranged from $151 to $210 over 180 days, translating to $301-$420 annually.
    • National annual excess costs for the elderly population were estimated between $457 million and $637 million.

    Conclusions:

    • Concurrent use of multiple antiulcerative agents is common despite a lack of supporting evidence for increased efficacy.
    • This practice incurs substantial excess costs and potential risks without additional therapeutic benefit.
    • Reducing duplicative AUA prescribing could lead to significant healthcare savings.