Analysis of proton pump inhibitor (PPI) medicines used in the management of gastrointestinal acid related disorders, June 2022
Page last updated: 21 October 2022
Drug utilisation sub-committee (DUSC)
June 2022
Abstract
Purpose
To review recent utilisation of PBS-listed proton pump inhibitor (PPI) medicines used in the management of gastrointestinal acid related disorders following Pharmaceutical Benefits Scheme (PBS) listing changes in May 2019 and March 2021.
Date of listing on the Pharmaceutical Benefits Scheme (PBS)
- Omeprazole was first listed on 1 August 1990 as an Authority Required listing.
- Lansoprazole was first listed on the 1 August 1994 as an Authority Required listing.
- Pantoprazole was first listed on the 1 November 1995 as an Authority Required listing.
- Rabeprazole was first listed on the 1 May 2001 as an Authority Required listing.
- Esomeprazole was first listed on the PBS on the 1 August 2002.
Data Source / methodology
Data extracted from the PBS data maintained by the Australian Government Department of Health and Aged Care, processed by Services Australia was used for the analyses.
Key Findings
- From 2013 to 2021, the number of patients supplied lansoprazole had remained relatively stable, whilst there was a slight decrease in the number of patients supplied omeprazole and rabeprazole. In Q1 2019, the number of patients supplied pantoprazole increased, overtaking the number of esomeprazole patients in Q4 2019. The number of pantoprazole patients continued to increase, while esomeprazole started decreasing in Q4 2018 and appeared to stabilise between Q2-Q3 2020.
- The number of high strength prescriptions remained relatively stable until 2019, where there was a decrease before stabilising. The number of low strength PPI prescriptions supplied also remained relatively stable until 2019 with a gradual increase occurring from 2019 to 2021. The standard strength of PPI medications was the most commonly prescribed, with small increases and decreases at every quarter from 2013 to 2021.
- In 2017 there were 611,154 initiating patients on PPI medication and in 2020 there were 494,347 initiating patients on PPI medication. In 2017 there were 145,903 (24%) patients first starting on a high dose of PPI medication. In 2020 there were 8,026 (2%) initiating patients on high dose of PPI. For first initiators in 2017, 20,309 (3%) patients went from a standard dose to high dose medication and in 2020 there was 5,896 (1%) patients starting on standard dose who transitioned to a high dose.
- The aim of the 2019 restriction changes was to reduce the number of patients using high dose formulations. The Defined Daily Doses (DDDs) analysis showed that there was a reduction in the DDDs for high dose listings. The overall DDDs for all PPIs showed there was an overall reduction in DDDs following the restriction changes. Even though total script utilisation (across all drugs) increased after the May 2019 restriction changes, the total number of DDDs decreased.
