title: The pharmacoeconomic impact of antimicrobial therapy for peptic ulcer disease in a large urban jail.
abstract: OBJECTIVE
  To determine the pharmacoeconomic impact of antimicrobial treatment of peptic ulcer disease (PUD) in a large urban jail.
  
  
  METHODS
  Retrospective comparison of PUD-related pharmacy and laboratory expenditures over a 2-year period before and after the institution of a PUD treatment protocol with the priority of Helicobacter pylori eradication for inmates in Rikers Island Correctional Facility.
  
  
  RESULTS
  After the protocol was adopted, total pharmacy-related and laboratory-related expenses for PUD care decreased by 40.2%, and expenditures for ranitidine declined by 52.2%. There was an increase in spending for antimicrobial agents and H. pylori antibody testing, but this was insignificant compared to the savings generated by decreased ranitidine usage. Annual savings in our facility as a result of this intervention were $123,449.
  
  
  CONCLUSIONS
  Modern therapeutic strategies for PUD aimed at eradicating H. pylori can result in significant savings in the institutional setting; these savings are largely attributable to the decreased usage of histamine-2 receptor antagonists.
authors.affiliation: Montefiore Rikers Island Health Services, USA.
authors.forename: J
authors.initials: J
authors.lastname: Shuter
authors.forename: D D
authors.initials: DD
authors.lastname: Fletcher
authors.forename: V J
authors.initials: VJ
authors.lastname: Simone
authors.forename: E Y
authors.initials: EY
authors.lastname: Bellin
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000191:economics / Q000627:therapeutic use; D001729:Bismuth / Q000191:economics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000191:economics; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000191:economics / Q000627:therapeutic use; D009519:New York City; D009942:Organometallic Compounds / Q000191:economics / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000191:economics; D011330:Prisons; D011899:Ranitidine / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D012459:Salicylates / Q000191:economics / Q000627:therapeutic use; D013752:Tetracycline / Q000191:economics / Q000627:therapeutic use; D014504:Urban Health
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D009942:Organometallic Compounds; D012459:Salicylates; D008795:Metronidazole; C015715:bismuth subsalicylate; D011899:Ranitidine; D013752:Tetracycline; D001729:Bismuth