Switching From Continuous to Intermittent Proton Pump Inhibitors Reduces Costs

According to a presentation at Digestive Disease Week 2018, use of intermittent intravenous proton pump inhibitors among patients with upper gastrointestinal bleeding was significantly cost-saving compared with continuous therapy. 

Yang Lei, MD, of the Internal Medicine Residency Program at the University of Calgary, and colleagues explained that recent research suggested that switching from continuous to intermittent proton pump inhibitors had the potential to reduce costs.

“A meta-analysis showed that intermittent intravenous proton pump inhibitors for 72 hours post-endoscopy was not inferior to continuous proton pump inhibitors for recurrent bleeding,” Dr Lei and colleagues wrote. “Local data suggests that there is a small savings with the use of intermittent intravenous proton pump inhibitors as compared to continuous proton pump inhibitors infusions although this only accounted for difference in medication costs.”

In order to determine how switching proton pump inhibitor therapy methods impacted the annual spending within an entire regional health zone of the Canadian Health Services, the researchers compared drug costs between the two therapies. They compared total volume of injection used and multiplied the per ml price in order to determine drug cost differences. Further, the researchers also measured length of stay costs by comparing the average length of stay between continuous and intermittent patients and multiplying it by the typical daily hospital price of an adult. 

Study results showed that of the 3607 patients who were diagnosed with upper gastrointestinal bleeding, 1669 patients received continuous therapy and 436 received intermittent therapy. The researchers found that the drug costs savings associated with intermittent use was $38,186.72 CAD. Further, they found that a reduced length of stay in the intermittent group (1.8 days) resulted in $3,433,371.43 CAD in annual cost savings. 

The researchers concluded that significant savings could be achieved by switching the default electronic order from continuous to intermittent for these patients.

“Specific amounts of savings for non-length of stay cost may differ from region to region, but the bulk of savings would be in length of stay-related cost which is the major driver of cost in all health jurisdictions,” Dr Lei and colleagues concluded.

—David Costill