What Is the True Cost of Proton Pump Inhibitors?

April 24, 2013, 1:30PM. By Heidi Turner

Detroit, MIAcid reflux is a prevalent health concern in the United States, with some estimates putting the rate of monthly acid reflux disease at around one-third of Americans. For that reason, many people turn to medications such as Nexium or other proton pump inhibitors to help with their medical condition. Concerns have been raised, however, that the risk of Nexium side effects when the drug is used long-term outweigh the potential benefits of the drug. Among reported side effects are an increased risk of fracture.

According to the over-the-counter label, Nexium is meant to be used for no more than 14 days during a year. But many patients use the drug as a preventive measure, to avoid any chance of developing acid reflux. This means that they take the medication far longer than they are meant to, putting themselves at risk of developing serious side effects.

One study that suggests an increased risk to patients who have no symptoms of acid reflux was published in July 2011 in the journal Archives of Surgery. The study examined more than 750 patients with gastroesophageal reflux disease who used a proton pump inhibitor. Researchers found that patients who had only mild symptoms of GERD, and those who had no symptoms at all, were 60 percent more likely to have a precancerous condition called Barrett’s esophagus. Patients who had more severe symptoms of GERD and took a proton pump inhibitor were less likely to have Barrett’s esophagus.

“Patients taking proton pump inhibitors were 61.3% and 81.5% more likely to have adenocarcinogenesis if they reported no severe typical or atypical GERD symptoms, respectively, compared with patients taking proton pump inhibitors, who reported that all symptoms were severe,” researchers wrote. In other words, if patients used a proton pump inhibitor but did not have severe symptoms of GERD, they were more likely to have a precancerous condition.

Meanwhile, a study published in 2010 in the American Journal of Managed Care found that overuse of proton pump inhibitors was associated with increased medical care costs. Researchers found that of almost 950 patients treated in ambulatory care with a proton pump inhibitor, approximately 36 percent received the medication for no documented appropriate indication.

“The total cost of inappropriate PPI use was $233,994 based on over-the-counter PPI costs and $1,566,252 based on average wholesale costs,” researchers wrote. They concluded that inappropriate use of proton pump inhibitors is associated with “substantial cost expenditure and with the potential for adverse events.”

The studies suggest that patients using proton pump inhibitors without symptoms of GERD not only face increased risks of health problems, but also increased medical costs.