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Trend analysis of proton pump inhibitor consumption and expenditure: The real-world evidence

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Abstract

Introduction

Proton pump inhibitors (PPIs) constitute a widely utilized pharmaceutical class, frequently associated with notable instances of therapeutic inappropriateness. Such patterns of misuse not only contribute to elevated healthcare expenditure, but may also exacerbate clinical conditions in certain patients.

Methods

A comprehensive analysis was conducted between 2019 and 2023 to assess all prescriptions dispensed using the Anatomical, Therapeutic and Chemical (ATC) classification system, which allowed trends among primary PPIs to be visualized. This was achieved by calculating the defined daily dose (DDD) and then defining the total expenditure incurred on these drugs.

Results

With regard to the prescription of PPIs, an upward trend in consumption was observed with a decreasing expenditure, due to the phenomena of drug generics and increased competition between pharmaceutical companies, ranging from €9,512,481.22 in the first six months of 2019 to €8,509,820.80 in the first six months of 2023. From 2019 to 2023, consumption increased by approximately 3 million DDDs for a total ranging from 18,483,167.59 DDDs to 21,480,871.00 DDDs. Pantoprazole and esomeprazole, the most expensive drugs compared to omeprazole, rabeprazole and lansoprazole, accounted for 61.4% of therapies in the first six months of 2023, up from 2019, where these two drugs were prescribed 54.9%.

Conclusion

Within this analysis, we provide an illustrative representation of the prescribing trends for PPIs within a European context. Omeprazole, rabeprazole and lansoprazole appear to be the cheapest drugs compared to pantoprazole and esomeprazole. However, the results show that the most widely used PPIs, despite their therapeutic equivalence, are precisely the high-cost ones, thus generating higher expenditure for central governments.

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Full availability of data and materials. All stated data can be provided on request to the reader.

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Authors and Affiliations

  1. Pharmaceutical Department, Asl Napoli 3 Sud, Dell’amicizia Street 22, 80035, Nola, Naples, Italy

    Francesco Ferrara

  2. Pharmaceutical Department, Asl Napoli 3 Sud, Marittima Street 3, 80056, Ercolano, Naples, Italy

    Maurizio Capuozzo

  3. Pharmaceutical Department, Asl Napoli 3 Sud, Castellammare, Naples, Italy

    Venere Celotto

  4. Istituto Nazionale Tumori Di Napoli, IRCCS “G. Pascale”, Via M. Semmola, 80131, Naples, Italy

    Alessandro Ottaiano

  5. Italian Society of Hospital Pharmacy (SIFO), SIFO Secretariat of the Lombardy Region, Carlo Farini Street, 81, 20159, Milan, Italy

    Roberto Langella

  6. School of Advanced Studies, University of Camerino, Via Madonna delle Carceri, 9, 62032, Camerino, Italy

    Andrea Zovi

Authors
  1. Francesco Ferrara
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  2. Maurizio Capuozzo
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  3. Venere Celotto
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  4. Alessandro Ottaiano
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  5. Roberto Langella
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  6. Andrea Zovi
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Contributions

Francesco Ferrara: Conceptualization, Writing - original draft, Methodology, Supervision, Validation. Maurizio Capuozzo: Writing - review and editing. Venere Celotto: Conceptualization, Writing - original draft. Alessandro Ottaiano: Supervision, Validation. Roberto Langella: Writing - review and editing. Andrea Zovi: Writing - review and editing.

Corresponding author

Correspondence to Andrea Zovi.

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FF, MC, VC, AO, RL and AZ declare no competing interests.

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The authors are solely responsible for the data and the content of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, the Indian Society of Gastroenterology or the printer/publishers are responsible for the results/ findings and content of this article.

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Ferrara, F., Capuozzo, M., Celotto, V. et al. Trend analysis of proton pump inhibitor consumption and expenditure: The real-world evidence. Indian J Gastroenterol (2024). https://doi.org/10.1007/s12664-023-01501-1

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