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. 2021 Jul;38(7):3937-3947.
doi: 10.1007/s12325-021-01784-w. Epub 2021 Jun 6.

Impact of Vonoprazan Triple-Drug Blister Packs on H. pylori Eradication Rates in Japan: Interrupted Time Series Analysis

Hisato Deguchi  1   2 , Hajime Yamazaki  3 , Tsukasa Kamitani  1 , Yosuke Yamamoto  1 , Shunichi Fukuhara  4
Affiliations

Impact of Vonoprazan Triple-Drug Blister Packs on H. pylori Eradication Rates in Japan: Interrupted Time Series Analysis

Hisato Deguchi et al. Adv Ther. 2021 Jul.

Abstract

Introduction: Helicobacter pylori eradication therapy requires a complex prescribing schedule combining clarithromycin, amoxicillin, and a proton-pump inhibitor (PPI) or potassium-competitive acid blocker (P-CAB, vonoprazan). To reduce the burden of complex prescribing and increase adherence, a vonoprazan triple-drug blister pack comprising all three medications was launched in June 2016. This study aimed to assess the impact of the combination blister pack on eradication success rate in Japan immediately after launch.

Methods: We performed an interrupted time series analysis using a large administrative claims database of 7,300,000 insured individuals. We identified 36,570 patients who received first-line clarithromycin triple therapy from June 2015 to May 2016 (prelaunch) and 35,721 who received the same therapy from July 2016 to June 2017 (post-launch). The primary outcome was the success rate of clarithromycin triple therapy and the secondary outcomes were proportion of vonoprazan use and proportion of combination blister pack use.

Results: The success rate of clarithromycin triple therapy increased by 2.44% (95% confidence interval [CI] 1.36-3.52; P < 0.0001) after the launch of the vonoprazan triple-drug blister pack. The proportion of vonoprazan use and proportion of combination blister pack use increased by 12.7% (95% CI 10.0-15.3; P < 0.0001) and 29.2% (95% CI 25.4-32.9; P < 0.0001), respectively.

Conclusions: Launch of the vonoprazan triple-drug blister pack had a significant impact on the success rate of clarithromycin triple therapy, with greater proportions of vonoprazan and combination blister pack use. Introducing an easy-to-use formulation may be effective in changing prescribing practice and subsequent patient outcomes.

Keywords: Drug packaging; Drug therapy; Helicobacter pylori; Interrupted time series analysis; Proton-pump inhibitors.

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Figures

Fig. 1
Fig. 1
Vonoprazan triple-drug blister pack (VONOSAP®): Contains vonoprazan, clarithromycin, and amoxicillin (from left to right)
Fig. 2
Fig. 2
Outcomes before and after launch of vonoprazan triple-drug blister pack in June 2016. a Success rate of clarithromycin triple therapy. b Proportion of vonoprazan use to overall PPIs and P-CAB use. c Proportion of triple-drug blister pack use. P-CAB potassium-competitive acid blockers, PPI proton-pump inhibitor
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