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. 2013 Mar 30;44(1):13-8.
eCollection 2013 Jan.

Prescribing patterns and economic costs of proton pump inhibitors in Colombia

Jorge Machado-Alba  1 , Alejandra Fernández  2 , Juan Daniel Castrillón  2 , Carlos Felipe Campo  2 , Luis Felipe Echeverri  2 , Andrés Gaviria  2 , Manuel José Londoño  2 , Sergio Andrés Ochoa  2 , Joaquín Octavio Ruíz  2
Affiliations

Prescribing patterns and economic costs of proton pump inhibitors in Colombia

Jorge Machado-Alba et al. Colomb Med (Cali). .

Abstract
in English, Spanish

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.

Keywords: Health care costs; drug costs; esomeprazole; lanzoprazole; omeprazole; pharmaceutical services.

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Conflict of interest statement

Conflict of interest: The authors declare that there is no real or potential conflict of interest regarding the possible publication of this work.

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