Inappropriate Medication Use and Cost Comparison Analysis of Proton Pump Inhibitors: Evidence from an Indian Tertiary Care Facility

Venkataraman, Rajesh; Rashid, Muhammed; Shrestha, Heamant

doi:10.2174/1574886315666200311120151

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…The cost analysis study become particularly crucial to provide better medical care to more patients at a lower cost while maintaining efficacy and safety to the greatest extent possible. 14 The economic situation in India, particularly in hemodialysis treatment, makes it difficult to pay for 80-90% of the treatment costs. 17 In this case, the findings of our study will be useful in the selection of low-cost drugs.…”

Section: Discussionmentioning

confidence: 99%

“…The percentage cost variation was calculated using the formula given by the previous literature. 7,14 Difference in the cost between branded and generic drugs Percentage cost savings = × 100 Cost of branded drug…”

Section: Cost-minimization Analysismentioning

confidence: 99%

“…Moreover, the CMA compares and measures input costs under the assumption that the outcome is equivalent between two alternatives which are clinically equivalent. 13,14 Pharmaceuticals used as supplementary systematic therapy are manufactured by numerous drug companies and sold under variety of brands at high prices that are unaffordable to the patients, particularly in developing countries like India. Whereas the generic medicines are accessible in the Indian market at a lower cost which are having the equal efficacy and safety.…”

Section: Introductionmentioning

confidence: 99%

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Cost-Minimization Analysis of Medications Used in the Management of End-stage Renal Disease

Naik¹,

Sreedhar²,

Muragundi³

et al. 2023

Ind. J. Pharm. Edu. Res

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Aim/Background: Several branded pharmaceuticals and generic medicines are available in the market for the management of End-Stage Renal Disease (ESRD) as a supportive care, and clinicians are unaware of the cost minimization and cost consequences aspects of these medications. Thus, this study aimed to compare the prices of branded versus generic medicines for ESRD treatment and to present the cost savings with a generic alternative. Materials and Methods: A prospective observational study was conducted among ESRD patients from three different tertiary care teaching hospitals in South India. The cost of branded pharmaceuticals were determined using the most recent current index of medical specialties, while the prices of generic medicines were accessed using the Pradhan Mantri Bhartiya Jan Aushadhi Pariyojana scheme, 2022. Results: The data were collected from 385 patients with ESRD. All Jan Aushadhi generic medicines were less expensive when compared to the branded medicines. The cost of ESRD medicines accessible in India varies greatly. The greatest difference in percentage cost savings were noted with amlodipine 5 mg tab (93.03%), voglibose 0.2mg/tab (88.10%), calcium carbonate + Vitamin D 3 supplements 500 mg tab (80.27%), torsemide 10 mg tab (78.01%), and hematopoietic agent, erythropoietin 2000 U/inj (75.38%). Conclusion: The haematopoietic medicines and antidiabetic insulin injections were the most expensive medicines among the study population. Our research indicates that replacing the generic medicines with the branded medicines could help in reducing the cost burden. Healthcare professionals may consider prescribing generic medicines for cost-savings.

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Section: Discussionmentioning

confidence: 99%

Section: Cost-minimization Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cost-Minimization Analysis of Medications Used in the Management of End-stage Renal Disease

Naik¹,

Sreedhar²,

Muragundi³

et al. 2023

Ind. J. Pharm. Edu. Res

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“…PPIs are widely used, prescribed, and are often the first-line agents for conditions like esophagitis, Zollinger-Ellison Syndrome, peptic ulcer disease [ 7 ], and in the management of IBD as well. Moreover, PPIs are among the most used over-the-counter medicine globally [ 8 ]. However, PPI may influence the local electrolyte balance and alter fluid acidification, which may cause immune and inflammatory reactions.…”

Section: Introductionmentioning

confidence: 99%

Proton pump inhibitors use and risk of inflammatory bowel diseases: a meta-analysis of observational studies

Shastri

Kantamneni

Rashid

et al. 2022

Medicine and Pharmacy Reports

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Background and objective. Proton Pump Inhibitors (PPIs) reduce gastric acid production and they are indicated for myriad gastrointestinal conditions. Prolonged use of PPI has been linked to the risk of inflammatory bowel disease (IBD) though this fact is not well established. We aimed to conduct a systematic review and meta-analysis to estimate the risk of IBD occurrence with PPI use. Methodology. The databases such as PubMed, Scopus, and Cochrane Library were accessed from inception to December 2020. Additionally, the bibliographic search and a random search in Google, Google Scholar, and ResearchGate were performed to find additional sources. The observational studies estimating the risk of IBD following the use of PPI, published in the English language were considered for this review. The methodological quality of included studies was assessed using the Modified Downs and Black checklist. Results. Eight out of 2038 studies with 157,758 participants were included in this meta-analysis. A significantly higher risk of IBD (adjusted odds ratio [aOR] 2.43; 95% Confidence Interval [CI] 1.18-5.02; P=0.02; n=6) was observed in participants taking PPIs for any indication. Moreover, a significant association was observed between PPI exposure on the different types of IBD such as ulcerative colitis and Crohn’s disease together (aOR: 3.60; 95% CI: 1.10-11.74), collagenous colitis (OR: 4.73; 95% CI: 1.99-11.22) and lymphocytic Colitis (OR: 3.77; 95% CI: 2.91- 4.87), but not with ulcerative colitis (P=0.47) and microscopic colitis (P=0.07) alone. Similarly, a significant association was observed among Europeans (aOR: 3.98; 95% CI: 2.36-6.71), but not with North American (aOR: 0.48; 95% CI: 0.01- 26.71) studies. Overall the study quality was good. Conclusion. The current evidence indicates that exposure to PPI is significantly associated with increased risk of IBD. Further, adequately powered studies from various parts of the world are needed for better quantification and generalizability of our findings. PROSPERO Protocol Registration Number: CRD42020209674

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“…In practice, however, not all PPIs are used following evidence-based guidelines, and irrational use is common. 4 – 6 Nearly USD 2 billion is spent globally every year for unnecessary PPI treatment, and inappropriate use of injectable PPIs (I-PPIs) accounts for 56% of all inappropriate PPI use. 7 In recent years, the irrational use of PPIs has become common in China, mainly involving unapproved indications and excessive dosages.…”

Section: Introductionmentioning

confidence: 99%

Continuous improvement on the rationality of prophylactic injectable PPIs usage by a clinical pharmacist-led guidance team at a Chinese tertiary teaching hospital

Hong

Gao

et al. 2020

J Int Med Res

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Objective We aimed to evaluate the effects of a clinical pharmacist-led-guidance-team (CPGT) on improving rational prophylactic injectable proton pump inhibitor use (PIPU) and to explore the application of the Plan–Do–Check–Act (PDCA) method in promoting rational PIPU. Methods We conducted a retrospective study among 814 patients at a Chinese tertiary teaching hospital from January 2017 to December 2018. We enrolled 98 patients before the PDCA; 297 and 419 patients were included in first- and second-round PDCA cycles, respectively. The CPGT established the criteria for PIPU and conducted interventions, including medical record reviews, provision of feedback, clinician education, and outcome analysis. We analyzed the appropriateness and costs of PIPU before and after establishment of the PDCA cycle. Results Implementation of continuous CPGT-led intervention and a PDCA cycle significantly decreased the rate of irrational PIPU (53.06% vs. 8.57%), including duration, administration route, indication, and dosing frequency. Costs of total (USD 211.28 ± 162.33 vs. 53.17 ± 22.32) and inappropriate (USD 76.70 ± 59.78 vs. 2.25 ± 3.86) PIPU per patient were significantly reduced. The target compliance rate was 107.56%. Conclusion A CPGT can have an effective role in improving rational PIPU and optimizing administration through a PDCA cycle, to attain improved clinical and economic outcomes.

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Inappropriate Medication Use and Cost Comparison Analysis of Proton Pump Inhibitors: Evidence from an Indian Tertiary Care Facility

Cited by 9 publications

References 22 publications

Cost-Minimization Analysis of Medications Used in the Management of End-stage Renal Disease

Cost-Minimization Analysis of Medications Used in the Management of End-stage Renal Disease

Proton pump inhibitors use and risk of inflammatory bowel diseases: a meta-analysis of observational studies

Continuous improvement on the rationality of prophylactic injectable PPIs usage by a clinical pharmacist-led guidance team at a Chinese tertiary teaching hospital

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