Skip to main content
Log in

Therapeutic and cost effectiveness of proton pump inhibitor regimens for idiopathic or drug-induced peptic ulcer complication

  • Research Articles
  • Drug Discovery and Development
  • Published:
Archives of Pharmacal Research Aims and scope Submit manuscript

Abstract

Peptic ulcer (PU) disease has a high rate of occurrence and recurrence in Korean and the selection of drug for treatment is diverse. In this study, the therapeutical effectiveness of regimens including proton pump inhibitors (PPI) was compared with the single PPI therapy. The clinical data were collected from 1,658 patients having idiopathic or drug-induced PU complication from a Medical Center in Daegu, Korea, and analyzed retrospectively based on the results of endoscopic examination, the drug history and the therapeutic cost depending on drugs used. The comparison of complete healing rate and recurrence rate showed no significant differences between the single PPI groups and the combination group with antacids, prokinetic agent or mucosa protectants. However, the combination therapy of PPI with mucosa protectants gave a slightly better therapeutic outcome than single PPI treatment in gastric ulcer patients. Comparatively, the combination of PPI with antacids significantly reduced the therapeutic effectiveness in duodenal ulcer patients. The analysis of cost-based therapeutic effectiveness reveals that any economic benefits in PU treatment were not gained by the combination of other class of ulcer drugs. Even though the rapidity of healing rate was not considered, it can be concluded that the PPI combination therapy might be not desirable in PU treatment. Particularly triplet or quartet combination therapy in PPI regimen was absolutely economically ineffective therapy in spite of the increase of medication costs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Al-Sabah, S., Barkun, A. N., Herba, K., Adam, V., Fallone, C., Mayrand, S., Pomier-Layrargues, G., Kennedy, W., and Bardou, M., Cost-effectiveness of proton pump inhibition before endoscopy in upper gastrointestinal bleeding. Clin. Gastroenterol. Hepatol., 6, 418–425 (2008).

    Article  PubMed  Google Scholar 

  • Barkun, A. N., Herba, K., Adam, V., Kennedy, W., Fallone, C. A., and Bardou, M., The cost-effectiveness of high-dose oral proton pump inhibition after endoscopy in the acute treatment of peptic ulcer bleeding. Aliment. Pharmacol. Ther., 20, 195–202 (2004).

    Article  PubMed  CAS  Google Scholar 

  • Barkun, A. N., Adam, V., Sung, J. J., Kulpers, E. J., Mössner, J., Jensen, D., Stuart, R., Lau, J. Y., Nauclér, E., Kilhamn, J., Granstedt, H., Lijas, B., and Lind, T., Cost effectiveness of high-dose intravenous esomeprazole for peptic ulcer bleeding. Pharmacoeconomics, 28, 217–230 (2010).

    Article  PubMed  Google Scholar 

  • Dean, B. B., Gano, A. D. Jr., Knight, K., Ofman, J. J., and Fass, R., Effectiveness of proton pump inhibitors in nonerosive reflux disease. Clin. Gastroenterol. Hepatol., 2, 656–664 (2004).

    Article  PubMed  CAS  Google Scholar 

  • Erstad, B. L., Cost-effectiveness of proton-pump inhibitor therapy for acute peptic ulcer-bleeding. Crit. Care Med., 32, 1277–1283 (2004).

    Article  PubMed  Google Scholar 

  • Holle, G. E., Pathophysiology and modern treatment of ulcer disease. Int. J. Mol. Med., 25, 483–491 (2010).

    Article  PubMed  CAS  Google Scholar 

  • Hughes, D. A., Bodger, K., Bytzer, P., de Herdt, D., and Dubois, D., Economic analysis of on-demand maintenance therapy with proton pump inhibitors in patients with nonerosive reflux disease. Pharmacoeconomics, 23, 1031–1042 (2005).

    Article  PubMed  CAS  Google Scholar 

  • Kim, J. H., Evidence-based treatment of peptic ulcer disease. J. Kor. Med. Assoc., 47, 85–100 (2004).

    Article  CAS  Google Scholar 

  • Kim, J. I., Pharmacological therapy in patients with bleeding peptic ulcers. Kor. J. Gastrointest. Endosc., 38, 247–253 (2009).

    Google Scholar 

  • Nam, T. M., Lee, D. H., Kang, K. P., Lee, J. H., Chung, J. I., Choi, H. C., Lee, S. B., Park, Y. S., Hwang, J. H., Kim, J. W., Jung, S. H., Kim, N., Jung, H. C., and Song, I. S., Clinical factors that potentially affect the treatment outcome of Helicobacter pylori eradication therapy with using a standard triple regimen in peptic ulcer patients. Kor. J. Gastrointest. Endosc., 36, 200–205 (2008).

    Google Scholar 

  • Park, J. H., Medical treatment of peptic ulcer disease in children: role of H2RA, PPI. Kor. J. Pediatr. Gastroenterol. Nutr., 10, S43–S52 (2007).

    Google Scholar 

  • Park, Y. M. and Oh, J. M., The study of different regimens prescribed for the treatment of peptic ulcer disease in a community hospital. Kor. J. Clin. Pharm., 10, 111–119(2000).

    Google Scholar 

  • Quan, C. and Talley, N. J., Management of peptic ulcer disease not related to H. pyrori or NSAIDs. Amer. J. Gastroenterol., 97, 2950–2961 (2002).

    Article  Google Scholar 

  • Remák, E., Brown, R. E., Yuen, C., and Robinson, A., Costeffectiveness comparison of current proton-pump inhibitors to treat gastro-oesophageal reflux disease in the UK. Curr. Med. Res. Opin., 21, 1505–1517 (2005).

    Article  PubMed  Google Scholar 

  • Soll, A. H., Weinstein, W. M., Kurata, J. H., and McCathy, D., Nonsteroidal antiinflammatory drugs and peptic ulcer disease. Ann. Intern. Med., 114, 307–319 (1991).

    PubMed  CAS  Google Scholar 

  • Spiegel, B. M., Dulai, G. S., Lim, B. S., Mann, N., Kanwal, F., and Gralnek, I. M., The cost-effectiveness and budget impact of intravenous versus oral proton pump inhibitors in peptic ulcer hemorrhage. Clin. Gastroenterol. Hepatol., 4, 988–997 (2006).

    Article  PubMed  CAS  Google Scholar 

  • Vonkeman, H. E., Braakman-Jensen, L. M. A., Klok, R. M., Postma, M. J., Brouwers, J. R. B. J., and van de Laar, M. A. F. J., Increment cost effectiveness of proton pump inhibitors for the prevention of non-steroidal anti-inflammatory drug ulcers: a pharmacoeconomic analysis tod a case-control study. Arthritis Res. Ther., 10, R144 (2008).

    Article  PubMed  Google Scholar 

  • Yu, K. D., Kim, N., Park, Y. S., Hwang, J. H., Kim, J. W., Lee, D. H., Jeong, S. H., Lee, K. H., Lee, H. S., Kwack, K. K., Kim. K. I., and Kim, C. H., Clinical characteristics of elderly Korean patients with peptic ulcer. Kor. J. Med., 71, 501–510 (2006).

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sung Chull Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nam, D.H., Park, S.Y., Park, J.M. et al. Therapeutic and cost effectiveness of proton pump inhibitor regimens for idiopathic or drug-induced peptic ulcer complication. Arch. Pharm. Res. 34, 443–449 (2011). https://doi.org/10.1007/s12272-011-0312-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12272-011-0312-z

Key words

Navigation