The objective of this study was to compare actual healthcare expenditures in GERD patients who were treated with proton pump inhibitor (PPI) or potassium-competitive acid blocker (P-CAB) as first-line therapy in real-world Japanese clinical settings. To date, only model analysis has been done to evaluate the cost-utility of acid-suppressant therapy in Japan. A cost utilization analysis was performed using a nationwide hospital-based claim database by extracting patients with GERD initiated on either PPI or P-CAB (242,102 pairs) and esomeprazole (EPZ) or P-CAB (241,825 pairs). In each comparison group, costs of health care were compared with propensity-score matched pairs. The switching rates of the initial acid suppressants were also investigated. Baseline characteristics were well-balanced after matching. In the comparison with PPI-first and P-CAB-first treatment strategies, EPZ-first and P-CAB-first treatments resulted in lower 3-year mean cumulative GERD-related and hospitalization expenditures per patient of 142,620 and 122,444, respectively. All hospitalization costs in the groups were unrelated to GERD. In 12 months, the PPI to P-CAB and P-CAB to PPI switching rates were 7.5% and 20.2%, respectively. Non-GERD-related hospitalization cost was greater in patients with GERD who were switched to PPI than in those who were switched to EPZ, whereas health care expenditure was lower in patients with GERD who were switched to EPZ than in those switched to P-CAB. PPI-first treatment was less costly than P-CAB-first treatment in terms of health care expenditures when excluding hospitalization expenses. The high switching rate from PPI to P-CAB in actual practice may partially explain the difference.
Source:journals.lww.com/jcge/Abstract/9000/Health_Care_Cost_Analysis_of_PPI_or_P_CAB_First.97303.aspx
