Marked increase in proton pump inhibitors use in Australia

Hollingworth, Samantha, Duncan, Emma L., & Martin, Jennifer H. (2010) Marked increase in proton pump inhibitors use in Australia. Pharmacoepidemiology and Drug Safety, 19(10), pp. 1019-1024.

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Objectives: To examine the trends in the prescribing of subsidised proton pump inhibitors (PPIs) and histamine receptor antagonists (H2RAs), in the Australian population from 1995 to 2006 to encourage discussion regarding appropriate clinical use. PPIs and H2RAs are the second highest drug cost to the publicly subsidised Pharmaceutical Benefits Scheme (PBS).

Design: Government data on numbers of subsidised scripts, quantity and doses for PPIs and H2RAs were analysed by gender and age, dose and indication.

Main outcome measure: Drug utilisation as DDD [defined daily dose]/1000 population/day.

Results: The use of combined PPIs increased by 1318%. Utilisation increased substantially after the relaxation of the subsidised indications for PPIs in 2001. Omeprazole had the largest market share but was substituted by its S-enantiomer esomeprazole after its introduction in 2002. There was considerable use in the elderly with the peak use being in those aged 80 years and over. The utilisation of H2RAs declined 72% over 12 years.

Conclusions: PPI use has increased substantially, not only due to substitution of H2RAs but to expansion in the overall market. Utilisation does not appear to be commensurate with prevalence of gastro-oesophageal reflux disease (GORD) nor with prescribing guidelines for PPIs, with significant financial costs to patients and PBS. This study encourages clinical discussion regarding quality use of these medicines. © 2010 John Wiley & Sons, Ltd.

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ID Code: 94198
Item Type: Journal Article
Refereed: Yes
Keywords: Gastro-oesophageal reflux disease, Prescribing, Proton pump inhibitors, Utilisation, cimetidine, esomeprazole, famotidine, lansoprazole, nizatidine, omeprazole, pantoprazole, proton pump inhibitor, rabeprazole, ranitidine, aged, article, Australia, drug cost, drug marketing, drug utilization, female, gastroesophageal reflux, Helicobacter infection, human, major clinical study, male, peptic ulcer, prescription, priority journal, treatment indication, Adolescent, Adult, Aged, 80 and over, Child, Child, Preschool, Drug Costs, Gastrointestinal Agents, Heartburn, Histamine H2 Antagonists, Humans, Middle Aged, Pharmacopoeias as Topic, Physician's Practice Patterns, Young Adult
DOI: 10.1002/pds.1969
ISSN: 1053-8569
Copyright Owner: Copyright 2010 John Wiley & Sons Ltd.
Deposited On: 29 Mar 2016 01:32
Last Modified: 29 Mar 2016 01:32

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