title: Comparison of health care resource utilization and costs among patients with GERD on once-daily or twice-daily proton pump inhibitor therapy.
abstract: BACKGROUND
  The purpose of this study was to assess differences in health care resource utilization and costs associated with once-daily and twice-daily proton pump inhibitor (PPI) therapy. Most patients with gastroesophageal reflux disease (GERD) achieve symptom control on once-daily PPI therapy, but approximately 20%-30% require twice-daily dosing.
  
  
  METHODS
  Patients were ≥18 years of age with at least one medical claim for GERD and at least two PPI claims from HealthCore's Integrated Research Database (HIRD(SM)) during 2004-2009. Patients were continuously eligible for 12 months before and after the index date (date of first PPI claim). Based on PPI dosing throughout the post-index period (quantity of medication dispensed/number of days supply), patients were classified as once-daily (dose ≤ 1.5 pills per day) or twice-daily (≥1.5) PPI users.
  
  
  RESULTS
  The study cohort included 248,386 patients with GERD (mean age 52.8 ± 13.93 years, 56% females) of whom 90% were once-daily and 10% were twice-daily PPI users. The Deyo-Charlson Comorbidity Index for once-daily and twice-daily PPI users was 0.70 ± 1.37 and 0.89 ± 1.54, respectively (P < 0.05). More once-daily patients had claims for Barrett's esophagus (5% versus 2%, P < 0.0001) than twice-daily patients. Post-index, higher proportions of twice-daily patients had at least one GERD-related inpatient visit (7% versus 5%), outpatient visit (60% versus 49%), and office visit (48% versus 38%) versus once-daily patients (P < 0.0001). Mean total GERD-related health care costs were $2065 ± $6636 versus $3749 ± $11,081 for once-daily and twice-daily PPI users, respectively (P < 0.0001).
  
  
  CONCLUSIONS
  Patients receiving twice-daily PPI therapy were likely to have more comorbid conditions and greater health care utilization and overall costs compared with patients using once-daily PPI therapy.
authors: Takeda Pharmaceuticals International Inc, Deerfield, IL.
authors: Reema
authors: R
authors: Mody
authors: Debra
authors: D
authors: Eisenberg
authors: Likun
authors: L
authors: Hou
authors: Siddhesh
authors: S
authors: Kamat
authors: Joseph
authors: J
authors: Singer
authors: Lauren B
authors: LB
authors: Gerson
keywords: database analysis; gastroesophageal reflux disease; health care resource utilization; proton pump inhibitors
references: Drugs. 1995 May;49(5):695-710
references: 7601011
references: Am J Gastroenterol. 2008 Oct;103(10):2446-53
references: 18684197
references: Gastroenterology. 1997 May;112(5):1448-56
references: 9136821
references: Dig Dis Sci. 2000 Apr;45(4):809-18
references: 10759254
references: Aliment Pharmacol Ther. 2011 Sep;34(5):555-67
references: 21714794
references: Am J Gastroenterol. 2006 Mar;101(3):470-8
references: 16542282
references: Curr Gastroenterol Rep. 2008 Jun;10(3):271-7
references: 18625138
references: Am J Gastroenterol. 2005 Jan;100(1):190-200
references: 15654800
references: Gastroenterology. 2002 May;122(5):1500-11
references: 11984534
references: Am J Gastroenterol. 2006 Sep;101(9):2128-38
references: 16848807
references: Curr Med Res Opin. 2009 Aug;25(8):1869-78
references: 19530980
references: Gastroenterology. 2008 Oct;135(4):1383-1391, 1391.e1-5
references: 18789939
references: Am J Gastroenterol. 2010 Feb;105(2):308-13
references: 19809412
references: Aliment Pharmacol Ther. 2007 Mar 15;25(6):709-14
references: 17311604
references: Am J Gastroenterol. 2000 Mar;95(3):788-92
references: 10710076
references: Aliment Pharmacol Ther. 2007 Sep 15;26(6):889-98
references: 17767473
references: J Am Board Fam Pract. 2005 Sep-Oct;18(5):393-400
references: 16148249
references: Dig Dis Sci. 2010 Jul;55(7):1911-7
references: 19830561
references: Aliment Pharmacol Ther. 2008 May;27(10):960-70
references: 18315585
references: Aliment Pharmacol Ther. 2008 Jun;27(12):1293-9
references: 18363892
references: Can J Gastroenterol. 2008 Mar;22(3):249-52
references: 18354753
references: Clin Gastroenterol Hepatol. 2012 Mar;10(3):247-53
references: 22155561