Cost-effectiveness of esomeprazole and pantoprazole as prophylaxis stress-related mucosal disease therapy in Intensive Care Unit

Authors

  • Ferina Damayanti Universitas Ahmad Dahlan
  • Endang Darmawan Faculty of Pharmacy, University of Ahmad Dahlan, Yogyakarta, Special Region of Yogyakarta, Indonesia
  • Setiawan Didik Faculty of Pharmacy, University of Muhammadiyah Purwokerto, Purwokerto, Central Java, Indonesia

Keywords:

Cost-effectiveness, Stress related mucosal bleeding , Prophylaxis, Esomeprazole, pantoprazole

Abstract

High risk of bleeding in a patient with a critical condition in an Intensive Care Unit (ICU) resulting requirement use needs prophylaxis for decrease bleeding incident during ICU is entirely accurate. This research is to determine the cost and effectiveness of esomeprazole and pantoprazole as Stress Related Mucosal Disease (SRMD) in the hospital ICU in Surakarta. This research is a retrospective cohort study. The subject is about all inpatients in ICU with the age of 18 to 65 who get esomeprazole and pantoprazole as stress ulcers prophylaxis during December 2016 – December 2018 that meets the criteria inclusion and exclusion criteria. Subjects on this research are 166 patients, where each group esomeprazole therapy (83 patients) and pantoprazole (83 patients). The effectiveness of treatment was observed based on the minor and major bleeding. Furthermore, the cost of therapy is calculated based on the total price paid by the patient for prophylaxis therapy on SRMD and treatment bleeding SRMD that count as Incremental cost-effectiveness ratio (ICER) value. The research result shows that no real difference between patients treated with esomeprazole (88%) and pantoprazole (80,7%) as prophylaxis therapy SRMD (p = 0.286). The use of esomeprazole can save money by IDR 13,456,368.00 (ICER) compared to pantoprazole for each cost reduction in the event of bleeding.

Downloads

Download data is not yet available.

References

Ali, T., & Harty, R. F. (2009). Stress-induced ulcer bleeding in critically ill patients. Gastroenterology Clinics, 38(2), 245-265.

Alshamsi, F., Belley-Cote, E., Cook, D., Almenawer, S. A., Alqahtani, Z., Perri, D., ... & Alhazzani, W. (2016). Efficacy and safety of proton pump inhibitors for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis of randomized trials. Critical Care, 20, 120.

Barkun, A. N., Bardou, M., Pham, C. Q. D., & Martel, M. (2012). Proton pump inhibitors vs. histamine 2 receptor antagonists for stress-related mucosal bleeding prophylaxis in critically ill patients: A meta-analysis. The American Journal of Gastroenterology, 107(4), 507-520.

Barkun, A. N., Adam, V., Martel, M., & Bardou, M. (2013). Cost-Effectiveness Analysis : Stress Ulcer Bleeding Prophylaxis with Proton Pump Inhibitors , H2 Receptor Antagonists. Value in Health, 16(1), 14-22.

Barletta, J. F., & Sclar, D. A. (2014). Use of proton pump inhibitors for the provision of stress ulcer prophylaxis: clinical and economic consequences. Pharmacoeconomics, 32(1), 5-13.

Clinical Pharmacy Working Committee. (2013). Critical Care Pharmacy Handbook. Selangor, Malaysia: Ministry of Health.

Cook, D. J., Griffith, L. E., Walter, S. D., Guyatt, G. H., Meade, M. O., Heyland, D. K., … Tryba, M. (2001). The attributable mortality and length of intensive care unit stay of clinically important gastrointestinal bleeding in critically ill patients. Critical Care, 5(6), 368.

Kerama, S. K., Okalebo, F. A., Nyamu, D. G., Guantai, E. M., Ndwigah, S. N., & Maru, S. M. (2014). Risk factors and management of stress ulcers in the critical care unit in a Kenyan referral hospital. African Journal of Pharmacology and Therapeutics, 3(2), 51-61.

Krag, M., Perner, A., & Møller, M. H. (2016). Stress ulcer prophylaxis in the intensive care unit. Current Opinion in Critical Care, 22(2), 186-190.

Li, L. F., Chan, R. L. Y., Lu, L., Shen, J., Zhang, L., Wu, W. K. K., ... & Cho, C. H. (2014). Cigarette smoking and gastrointestinal diseases: the causal relationship and underlying molecular mechanisms. International journal of molecular medicine, 34(2), 372-380.

Maclaren, R., & Campbell, J. (2014). Cost-effectiveness of histamine receptor-2 antagonist versus proton pump inhibitor for stress ulcer prophylaxis in critically ill patients. Critical Care Medicine, 42(4), 809-815.

MacLaren, R., Reynolds, P. M., & Allen, R. R. (2014). Histamine-2 receptor antagonists vs proton pump inhibitors on gastrointestinal tract hemorrhage and infectious complications in the intensive care unit. JAMA internal medicine, 174(4), 564-574.

Maity, P., Biswas, K., Roy, S., Banerjee, R. K., & Bandyopadhyay, U. (2003). Smoking and the pathogenesis of gastroduodenal ulcer–recent mechanistic update. Molecular and cellular biochemistry, 253(1), 329-338.

Marik, P. E., Vasu, T., Hirani, A., & Pachinburavan, M. (2010). Stress ulcer prophylaxis in the new millennium: A systematic review and meta-analysis. Critical Care Medicine, 38(11), 2222-2228.

Mohebbi, L., & Hesch, K. (2009, October). Stress ulcer prophylaxis in the intensive care unit. In Baylor University Medical Center Proceedings (Vol. 22, No. 4, pp. 373-376). Taylor & Francis.

Schupp, K. N., Schrand, L. M., & Mutnick, A. H. (2003). A cost-effectiveness analysis of stress ulcer prophylaxis. Annals of Pharmacotherapy, 37(5), 631-635.

Sesler, J. M. (2007). Stress-related mucosal disease in the intensive care unit: an update on prophylaxis. AACN Advanced Critical Care, 18(2), 119-128.

Stollman, N., & Metz, D. C. (2005). Pathophysiology and prophylaxis of stress ulcer in intensive care unit patients. Journal of Critical Care, 20(1), 35-45.

Sukengtyas, D. A. T., Andayanti, T. M., & Budiarti L. E. (2017). Effectivity and Cost Analysis of Omeprazole and Pantoprazole For Stress Related Mucosal Disease Prophylaxis in ICU. Journal of Management and Pharmacy Practice, 7(2), 57-64.

Zheng, R. N. (2009). Comparative study of omeprazole, lansoprazole, pantoprazole and esomeprazole for symptom relief in patients with reflux esophagitis. World Journal of Gastroenterology, 15(8), 990-995.

Downloads

Published

2021-10-07

How to Cite

Damayanti, F., Darmawan, E., & Didik, S. (2021). Cost-effectiveness of esomeprazole and pantoprazole as prophylaxis stress-related mucosal disease therapy in Intensive Care Unit . Farmasains : Jurnal Farmasi Dan Ilmu Kesehatan, 6(1), 43–48. Retrieved from https://ejournal.umm.ac.id/index.php/farmasains/article/view/16305

Issue

Section

Articles