Prescribing patterns and economic costs of proton pump inhibitors in Colombia

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.

Keywords
Health care costs, drug costs, pharmaceutical services, omeprazole, esomeprazole, lanzoprazole