Abstract
Objective:
The purpose of this study was to measure the patient acceptance, as well as the individual and provincial cost savings, of switching from other proton pump inhibitor (PPI) therapies to the less costly rabeprazole.
Design and setting:
This was an uncontrolled, prospective study conducted at a community pharmacy in conjunction with the physicians at the local medical clinic.
Patients:
Male and female patients over 18 years of age who were currently taking a PPI (omeprazole, lansoprazole, pantoprazole) regularly and who were under the care of a participating physician were eligible. Patients who were pregnant or breast-feeding were excluded. All patients were switched from their current PPI therapy to rabeprazole 20 mg daily, except for two patients, whose previous dose of omeprazole 20 mg twice daily was changed to rabeprazole 20 mg twice daily.
Results:
Twenty-six patients were enrolled. All patients were Caucasian; 15/26 (58%) were female, and 11/26 (42%) were male; ages ranged from 43 to 89 years. The PPI therapy being used by patients was omeprazole 20 mg, 77% (20/26); pantoprazole 40 mg, 11.5% (3/26); and lansoprazole 30 mg, 11.5% (3/26). At a six-month follow-up (minimum four months of rabeprazole therapy), seven (26.9%) patients had switched back to their original PPI therapy, while 19 (73.1%) had continued on rabeprazole. Five of the seven (71.4%) patients returned to omeprazole therapy, two (28.6%) returned to lansoprazole, and none (0%) returned to pantoprazole. Annual combined cost savings to individual patients was calculated at $4617.48; cost savings to the provincial government were $5083.56.
Conclusion:
Based on the literature, on the fact that 73.1% of patients found rabeprazole to be equivalent in efficacy and tolerability to the other more costly PPIs, and on the potential cost savings demonstrated, we believe that rabeprazole should be considered as a first choice for PPI therapy.
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