Prescribing patterns and economic costs of proton pump inhibitors in Colombia / Patrones de prescripción y costos económicos de inhibidores de bomba de protones en Colombia

Objective:To determine the prescribing patterns for protonpump inhibitors and to estimate the economic cost of their usein a group of patients affiliated with the Colombian Health Sys-tem.Methods:This is a descriptive observational study. Data foranalysis consisted of prescriptions dispensed between October1st, 2010 and October 31st, 2010 and were collected from a sys-tematic database of 4.2 million members. Socio-demographicvariables were considered along with the defined daily dose,comedication, convenience of the indication for proton pumpinhibitor use and costs.Results:In this study, 113,560 prescriptions were dispensed in89 cities, mostly to women (57.6 percent) with a mean age of 54.4 ±18.7 years; the drugs were omeprazole (n=111,294; 97.81 percent),esomeprazole (n=1,378; 1.2 percent), lansoprazole (n=524; 0.4 percent),pantoprazole and rabeprazole. The indication for 87,349 of theformulas (76.9 percent) was justified and statistically associated withthe use of NSAIDs, antithrombotics, corticosteroids, anti-ul-cer, antibiotics and prokinetics. No justification was found for26,211 (23.1 percent) of the prescriptions, which were associated withantidiabetics, antihypertensives,hypolipidemics andothers(p <0.001). The annual justified cost was estimated to beUS$ 1,654,701 and the unjustified cost was estimated tobe U.S. $ 2,202,590, as calculated using the minimum re-ference prices.

Prescribing patterns and economic costs of proton pump inhibitors in Colombia.

OBJECTIVE: To determine the prescribing patterns for proton pump inhibitors and to estimate the economic cost of their use in a group of patients affiliated with the Colombian Health System. METHODS: This is a descriptive observational study. Data for analysis consisted of prescriptions dispensed between October 1st, 2010 and October 31st, 2010 and were collected from a systematic database of 4.2 million members. Socio-demographic variables were considered along with the defined daily dose,comedication, convenience of the indication for proton pump inhibitor use and costs. RESULTS: In this study, 113,560 prescriptions were dispensed in 89 cities, mostly to women (57.6%) with a mean age of 54.4 ± 18.7 years; the drugs were omeprazole (n= 111.294; 97.81%),esomeprazole (n= 1.378; 1.2%), lansoprazole (n= 524; 0.4%), pantoprazole and rabeprazole. The indication for 87.349 of the formulas (76.9%) was justified and statistically associated with the use of NSAIDs, antithrombotics, corticosteroids, anti-ulcer, antibiotics and prokinetics. No justification was found for 26.211 (23.1%) of the prescriptions, which were associated with antidiabetics, antihypertensives, hypolipidemics and others (p <0.001).The annual justified cost was estimated to be US$ 1,654,701 and the unjustified cost was estimated to be U.S. $2,202,590, as calculated using the minimum reference prices. DISCUSSION: Each month, the Colombian health system is overloaded by unjustified costs that include payments for non-approved indications of proton pump inhibitors and for drugs outside the list of essential medications. This issue is contributing to rising costs of healthcare in Colombia.

OBJETIVOS: Determinar los patrones de prescripción de inhibidores de la bomba de protones y estimar el costo económico que genera su utilización en pacientes afiliados al Sistema General de Seguridad Social en Salud de Colombia. METODOLOGÍA: Estudio descriptivo observacional. Se analizarondatos de formulas dispensadas entre 1 y 31 de octubre de 2010 de una base de datos sistematizada de 4.2 millones de afiliados.Se consideraron variables socio-demograficas, dosis diaria definida,comedicación recibida, conveniencia o no del tipo de indicación de IBP y costos. RESULTADOS: Se dispensaron 113 560 formulas en 89 municipios,principalmente a mujeres (57.6%); promedio de edad 54.4±18.7 años; los medicamentos fueron omeprazol (n= 111294, 97.8%),esomeprazol (n= 1378, 1.2%), lanzoprazol (n= 524, 0.4%), pantoprazol y rabeprazol a dosis diarias definidas adecuadas. Se halló justificación en la indicación de 87349 fórmulas (76.9%) asociadas estadísticamente con uso de AINEs, antitrombóticos, corticoides, antiulcerosos, antibióticos, procinéticos, y sin justificación 26211 (23.1%) asociadas a antidiabéticos, antihipertensivos e hipolipemiantes y otros (p <0.001). El costo anual justificado fue de US$1.654.701 y no justificado de U.S.$2,202,590 empleando mínimos precios de referencia. DISCUSIÓN: Mensualmente se está cargando al sistema de salud colombiano con costos no justificados del uso de inhibidores de bomba de protones en indicaciones no aprobadas y con medicamentos por fuera del listado de esenciales que contribuyen a encarecer la atención sanitaria.