Comparison of health care resource utilization and costs among patients with GERD on once-daily or twice-daily proton pump inhibitor therapy

• Main Authors: Mody R (Author), Eisenberg D (Author), Hou L (Author), Kamat S (Author), Singer J (Author), Gerson LB (Author)
• Format: Book
• Published: Dove Medical Press, 2013-04-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Reema Mody,1 Debra Eisenberg,2 Likun Hou,2 Siddhesh Kamat,2 Joseph Singer,2 Lauren B Gerson3 1Takeda Pharmaceuticals International Inc, Deerfield, IL, 2HealthCore Inc, Wilmington, DE, 3Stanford University School of Medicine, Stanford, CA, USA Background: The purpose of this study was to assess differences in health care resource utilization and costs associated with once-daily and twice-daily proton pump inhibitor (PPI) therapy. Most patients with gastroesophageal reflux disease (GERD) achieve symptom control on once-daily PPI therapy, but approximately 20%&ndash;30% require twice-daily dosing. Methods: Patients were &ge;18 years of age with at least one medical claim for GERD and at least two PPI claims from HealthCore&#39;s Integrated Research Database (HIRDSM) during 2004&ndash;2009. Patients were continuously eligible for 12 months before and after the index date (date of first PPI claim). Based on PPI dosing throughout the post-index period (quantity of medication dispensed/number of days supply), patients were classified as once-daily (dose &le; 1.5 pills per day) or twice-daily (&ge;1.5) PPI users. Results: The study cohort included 248,386 patients with GERD (mean age 52.8 &plusmn; 13.93 years, 56% females) of whom 90% were once-daily and 10% were twice-daily PPI users. The Deyo-Charlson Comorbidity Index for once-daily and twice-daily PPI users was 0.70 &plusmn; 1.37 and 0.89 &plusmn; 1.54, respectively (P < 0.05). More once-daily patients had claims for Barrett&#39;s esophagus (5% versus 2%, P < 0.0001) than twice-daily patients. Post-index, higher proportions of twice-daily patients had at least one GERD-related inpatient visit (7% versus 5%), outpatient visit (60% versus 49%), and office visit (48% versus 38%) versus once-daily patients (P < 0.0001). Mean total GERD-related health care costs were $2065 &plusmn; $6636 versus $3749 &plusmn; $11,081 for once-daily and twice-daily PPI users, respectively (P < 0.0001). Conclusion: Patients receiving twice-daily PPI therapy were likely to have more comorbid conditions and greater health care utilization and overall costs compared with patients using once-daily PPI therapy. Keywords: gastroesophageal reflux disease, proton pump inhibitors, health care resource utilization, database analysis

Item Description

1178-6981