Marked increase in proton pump inhibitors use in Australia
Marked increase in proton pump inhibitors use in Australia
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DOI：
10.1002/pds.1969
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发表时间：
2010-10-01
影响因子：
2.6
通讯作者：
Martin，Jennifer H.
中科院分区：
文献类型：
--
作者：
Hollingworth，Samantha;Duncan，Emma L.;Martin，Jennifer H.
研究1995年至2006年澳大利亚人群中质子泵抑制剂（PPI）和组胺受体拮抗剂（H2 RAs）处方的趋势，以鼓励关于适当临床使用的讨论。PPIs和H2 RA是第二高的药物成本的公共补贴的药物福利计划（PBS）。设计政府数据的数量补贴脚本，数量和剂量的PPIs和H2 RA进行了分析，性别和年龄，剂量和indication.Main结果measureDrug utilization作为DDD [定义的每日剂量]/1000人口/day.ResultsThe使用组合PPIs增加了1318%。在二零零一年放宽生产力平价药物的资助适应症后，使用率大幅上升。奥美拉唑拥有最大的市场份额，但在2002年推出后被其S-对映异构体埃索美拉唑取代。老年人使用量很大，80岁及以上的人使用量最高。H2 RAs的利用率下降了72%over 12 years.ConclusionsPPI的使用大幅增加，不仅是由于H2 RAs的替代，但在整体市场的扩张。使用似乎与胃食管反流病（GORD）的患病率不相称，也与PPI的处方指南不相称，给患者和PBS带来了巨大的经济成本。这项研究鼓励临床讨论这些药物的质量使用。版权所有© 2010约翰威利父子有限公司.
ObjectivesTo examine the trends in the prescribing of subsidised proton pump inhibitors (PPIs) and histamine receptor antagonists (H2RAs), in the Australian population from 1995 to 2006 to encourage discussion regarding appropriate clinical use. PPIs and H2RAs are the second highest drug cost to the publicly subsidised Pharmaceutical Benefits Scheme (PBS).DesignGovernment data on numbers of subsidised scripts, quantity and doses for PPIs and H2RAs were analysed by gender and age, dose and indication.Main outcome measureDrug utilisation as DDD [defined daily dose]/1000 population/day.ResultsThe use of combined PPIs increased by 1318%. Utilisation increased substantially after the relaxation of the subsidised indications for PPIs in 2001. Omeprazole had the largest market share but was substituted by its S‐enantiomer esomeprazole after its introduction in 2002. There was considerable use in the elderly with the peak use being in those aged 80 years and over. The utilisation of H2RAs declined 72% over 12 years.ConclusionsPPI use has increased substantially, not only due to substitution of H2RAs but to expansion in the overall market. Utilisation does not appear to be commensurate with prevalence of gastro‐oesophageal reflux disease (GORD) nor with prescribing guidelines for PPIs, with significant financial costs to patients and PBS. This study encourages clinical discussion regarding quality use of these medicines. Copyright © 2010 John Wiley & Sons, Ltd.