Canadian Pharmacists Journal / Revue des Pharmaciens du Canada

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.

This was an uncontrolled, prospective study conducted at a community pharmacy in conjunction with the physicians at the local medical clinic.

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.

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.

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.

The Newfoundland and Labrador Centre for Health Information has been mandated to build a provincial Health Information Network (HIN). Phase I, Unique Personal Identifier/Client Registry, is complete. Phase II, the Newfoundland and Labrador Pharmacy Network (Pharmacy Network), will provide integration among community and institutional pharmacies, the Newfoundland and Labrador Prescription Drug Program, hospital emergency rooms, and physician offices. This study was carried out to determine community pharmacists' perceived value of a pharmacy network pre-implementation.

A four-part questionnaire was designed using a literature review and a pilot study. In December 2002, questionnaires were mailed to all 435 community pharmacists in the province.

Overall, 90.3% of community pharmacists agreed that drug utilization review would be an important function of the Pharmacy Network. The perceived value of computerized physician order entry was high. Removing problems with illegible handwriting received the strongest support (97.2%). Payment for providing various levels of pharmaceutical care also received strong support. The perceived value of a pharmacy network differed among community pharmacists with respect to age, sex, education, years in practice, and place of business.

The results contributed important baseline information about community pharmacists' expectations pre-implementation. They also provided benchmarks for future comparative studies that measure perceived value after implementation of the Pharmacy Network.