Rational Selection Of Proton Pump Inhibitors (Ppis) Through An Objective Scoring System For Effective Formulary Management
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Date
2011-06
Authors
Lim, Lynette Chu Ann
Journal Title
Journal ISSN
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Publisher
Universiti Sains Malaysia
Abstract
Rational drug selection is fundamental for effective formulary management. The rationale of an objective scoring system is to establish and make available drugs which are proven to be the most efficacious, safe and cost-effective without compromising the quality of patient care. The aims of Part 1 of the study were to develop an objective scoring system by determining the criteria for 5 available PPIs i.e. esomeprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole as well as to assign scores according to the importance in the evaluation process for the inclusion and exclusion of PPIs for the indication of GERD. Part 2 of the study was a case study aim to review and compare the usage and expenditure of PPI drugs used in Serdang Hospital with the most preferred PPI obtained in Part 1 of the study. This study also aims to determine appropriate cost saving measure in the treatment of acid related disease requiring PPIs. In the first part of the study, the higher the assigned score, the higher importance the criterion is. Two hundred were assigned to documentation, 300 points for efficacy, 200 points for safety and 300 points for cost. Total points were 1000. A convenience sampling method was used to generate the sample size of the participants in this survey. Self-administered questionnaire was distributed to 165 specialists / lecturers and medical officers in various out-patient clinics in 6 selected hospitals in Selangor and Kuala Lumpur. In the second part of the study, a retrospective study was carried out to review all prescriptions containing PPI drugs prescribed by the medical, gastroenterology, surgical, nephrology and cardiology out-patient clinics in Serdang Hospital. The number of prescriptions,
usage and expenditure of PPI drugs were analyzed. Further analysis were undertaken to estimate the potential savings that could be achieved by replacing esomeprazole, lansoprazole, pantoprazole and rabeprazole with the generic brand omeprazole. Out of 165 questionnaires distributed, only 73 questionnaires were successfully completed and returned (response rate = 44.2%). The scoring system showed that omeprazole was the most preferred PPI, followed by lansoprazole, pantoprazole, esomeprazole and rabeprazole.
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Keywords
Rational drug selection is fundamental , for effective formulary management