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Marked increase in proton pump inhibitors use in Australia
Author(s) -
Hollingworth Samantha,
Duncan Emma L,
Martin Jennifer H
Publication year - 2010
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.1969
Subject(s) - medicine , esomeprazole , omeprazole , population , pharmaceutical benefits scheme , subsidy , proton pump inhibitor , pharmacology , environmental health , medical prescription , economics , market economy
Objectives To examine the trends in the prescribing of subsidised proton pump inhibitors (PPIs) and histamine receptor antagonists (H 2 RAs), in the Australian population from 1995 to 2006 to encourage discussion regarding appropriate clinical use. PPIs and H 2 RAs 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 H 2 RAs 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 H 2 RAs declined 72% over 12 years. Conclusions PPI use has increased substantially, not only due to substitution of H 2 RAs 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. Copyright © 2010 John Wiley & Sons, Ltd.