Publicação
Patterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health system
| Resumo: | Background: Proton-pump-inhibitors (PPIs) are overprescribed, posing challenges to patients and healthcare systems. In Portugal, the public National Health Service (NHS) provides universal coverage and reimburses medication regardless of prescription origin, i.e., public or private. This study aimed to compare PPIs outpatient prescription patterns and costs among older adults in the private and public sectors. Methods: A nationwide retrospective ecological study was conducted on PPIs prescribed for older adults in Portugal from 2020–2022. Data on defined daily doses (DDDs) and prices were obtained from a national public database by healthcare sector, sex, and age group (65–74, ≥ 75 years). The market share of DDD per 1000 older adults per day and the mean price per DDD (€/DDD) for all PPIs substances were compared between the public and private sectors. Results: PPIs-DDDs accounted for 5.3% of all outpatient DDDs prescribed in the private sector and 5.9% in the public sector. The private sector prescribed PPIs at a 20% higher price (0.126 €/DDD) than the public (0.106 €/DDD), with greater differences among the most expensive substances (rabeprazole, lansoprazole and esomeprazole). Omeprazole (cheapest) was mostly prescribed in the public sector. In the private sector, a similar pattern was observed among those aged ≥ 75 years, whereas esomeprazole was most prescribed for those aged 65–74 years. Conclusions: Given the widespread prescription of PPIs and the associated cost, it is crucial to reinforce incentives to promote rational PPIs prescription and encourage deprescription when necessary, in both sectors. Since the NHS also reimburses medications prescribed in private units, implementing monitoring measures and financial incentives to promote responsible prescribing in this sector should also be considered. |
|---|---|
| Autores principais: | Romano, Sónia |
| Outros Autores: | Rodrigues, António Teixeira; Torre, Carla; Perelman, Julian |
| Assunto: | Overprescribing Patterns Private Proton-pump inhibitors Public Rational prescribing Health Policy SDG 3 - Good Health and Well-being |
| Ano: | 2025 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade Nova de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório Institucional da UNL |
| _version_ | 1868982810190020608 |
|---|---|
| author | Romano, Sónia |
| author2 | Rodrigues, António Teixeira Torre, Carla Perelman, Julian |
| author2_role | author author author |
| author_facet | Romano, Sónia Rodrigues, António Teixeira Torre, Carla Perelman, Julian |
| author_role | author |
| contributor_name_str_mv | Centro de Investigação em Saúde Pública (CISP/PHRC) Comprehensive Health Research Centre (CHRC) - Pólo ENSP Escola Nacional de Saúde Pública (ENSP) BioMed Central (BMC) RUN |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Romano, Sónia\"},{\"Person.name\":\"Rodrigues, António Teixeira\"},{\"Person.name\":\"Torre, Carla\"},{\"Person.name\":\"Perelman, Julian\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Centro de Investigação em Saúde Pública (CISP/PHRC) Comprehensive Health Research Centre (CHRC) - Pólo ENSP Escola Nacional de Saúde Pública (ENSP) BioMed Central (BMC) RUN |
| datacite.creators.creator.creatorName.fl_str_mv | Romano, Sónia Rodrigues, António Teixeira Torre, Carla Perelman, Julian |
| datacite.date.Accepted.fl_str_mv | 2025-12-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2025-05-20T21:21:34Z |
| datacite.date.embargoed.fl_str_mv | 2025-05-20T21:21:34Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Overprescribing Patterns Private Proton-pump inhibitors Public Rational prescribing Health Policy SDG 3 - Good Health and Well-being |
| datacite.titles.title.fl_str_mv | Patterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health system comparing public and private prescribing |
| dc.contributor.none.fl_str_mv | Centro de Investigação em Saúde Pública (CISP/PHRC) Comprehensive Health Research Centre (CHRC) - Pólo ENSP Escola Nacional de Saúde Pública (ENSP) BioMed Central (BMC) RUN |
| dc.creator.none.fl_str_mv | Romano, Sónia Rodrigues, António Teixeira Torre, Carla Perelman, Julian |
| dc.date.Accepted.fl_str_mv | 2025-12-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2025-05-20T21:21:34Z |
| dc.date.embargoed.fl_str_mv | 2025-05-20T21:21:34Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10362/183246 |
| dc.language.none.fl_str_mv | eng |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Overprescribing Patterns Private Proton-pump inhibitors Public Rational prescribing Health Policy SDG 3 - Good Health and Well-being |
| dc.title.fl_str_mv | Patterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health system comparing public and private prescribing |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Background: Proton-pump-inhibitors (PPIs) are overprescribed, posing challenges to patients and healthcare systems. In Portugal, the public National Health Service (NHS) provides universal coverage and reimburses medication regardless of prescription origin, i.e., public or private. This study aimed to compare PPIs outpatient prescription patterns and costs among older adults in the private and public sectors. Methods: A nationwide retrospective ecological study was conducted on PPIs prescribed for older adults in Portugal from 2020–2022. Data on defined daily doses (DDDs) and prices were obtained from a national public database by healthcare sector, sex, and age group (65–74, ≥ 75 years). The market share of DDD per 1000 older adults per day and the mean price per DDD (€/DDD) for all PPIs substances were compared between the public and private sectors. Results: PPIs-DDDs accounted for 5.3% of all outpatient DDDs prescribed in the private sector and 5.9% in the public sector. The private sector prescribed PPIs at a 20% higher price (0.126 €/DDD) than the public (0.106 €/DDD), with greater differences among the most expensive substances (rabeprazole, lansoprazole and esomeprazole). Omeprazole (cheapest) was mostly prescribed in the public sector. In the private sector, a similar pattern was observed among those aged ≥ 75 years, whereas esomeprazole was most prescribed for those aged 65–74 years. Conclusions: Given the widespread prescription of PPIs and the associated cost, it is crucial to reinforce incentives to promote rational PPIs prescription and encourage deprescription when necessary, in both sectors. Since the NHS also reimburses medications prescribed in private units, implementing monitoring measures and financial incentives to promote responsible prescribing in this sector should also be considered. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://run.unl.pt/bitstreams/390bd578-88df-4d44-bdad-12875409fc94/download |
| id | run_fb17cc2da9397f04733db94b340c8f25 |
| identifier.url.fl_str_mv | http://hdl.handle.net/10362/183246 |
| inst_facet_str | urn:organizationAcronym:unl{{{_:::_}}}Universidade Nova de Lisboa |
| instacron_str | unl |
| institution | Universidade Nova de Lisboa |
| instname_str | Universidade Nova de Lisboa |
| language | eng |
| network_acronym_str | run |
| network_name_str | Repositório Institucional da UNL |
| oai_identifier_str | oai:run.unl.pt:10362/183246 |
| organization_str_mv | urn:organizationAcronym:unl |
| person_str_mv | Romano, Sónia Rodrigues, António Teixeira Torre, Carla Perelman, Julian |
| publishDate | 2025 |
| repo_facet_str | urn:repositoryAcronym:run{{{_:::_}}}Repositório Institucional da UNL |
| reponame_str | Repositório Institucional da UNL |
| repository_id_str | urn:repositoryAcronym:run |
| service_str_mv | urn:repositoryAcronym:run |
| spelling | engenBackground: Proton-pump-inhibitors (PPIs) are overprescribed, posing challenges to patients and healthcare systems. In Portugal, the public National Health Service (NHS) provides universal coverage and reimburses medication regardless of prescription origin, i.e., public or private. This study aimed to compare PPIs outpatient prescription patterns and costs among older adults in the private and public sectors. Methods: A nationwide retrospective ecological study was conducted on PPIs prescribed for older adults in Portugal from 2020–2022. Data on defined daily doses (DDDs) and prices were obtained from a national public database by healthcare sector, sex, and age group (65–74, ≥ 75 years). The market share of DDD per 1000 older adults per day and the mean price per DDD (€/DDD) for all PPIs substances were compared between the public and private sectors. Results: PPIs-DDDs accounted for 5.3% of all outpatient DDDs prescribed in the private sector and 5.9% in the public sector. The private sector prescribed PPIs at a 20% higher price (0.126 €/DDD) than the public (0.106 €/DDD), with greater differences among the most expensive substances (rabeprazole, lansoprazole and esomeprazole). Omeprazole (cheapest) was mostly prescribed in the public sector. In the private sector, a similar pattern was observed among those aged ≥ 75 years, whereas esomeprazole was most prescribed for those aged 65–74 years. Conclusions: Given the widespread prescription of PPIs and the associated cost, it is crucial to reinforce incentives to promote rational PPIs prescription and encourage deprescription when necessary, in both sectors. Since the NHS also reimburses medications prescribed in private units, implementing monitoring measures and financial incentives to promote responsible prescribing in this sector should also be considered.application/pdfenPatterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health systemSubtitleencomparing public and private prescribingRomano, SóniaRodrigues, António TeixeiraTorre, CarlaPerelman, JulianCentro de Investigação em Saúde Pública (CISP/PHRC)Comprehensive Health Research Centre (CHRC) - Pólo ENSPEscola Nacional de Saúde Pública (ENSP)BioMed Central (BMC)HostingInstitutionOrganizationalRUNe-mailmailto:run@unl.ptrun@unl.ptISSNIsPartOf1472-6963URNIsPartOfPURE: 116481395URNIsPartOfPURE UUID: 6881a7f0-b7e3-4d89-8445-c1b3d5f61d37URNIsPartOfScopus: 85214237176URNIsPartOfPubMed: 39762802URNIsPartOfPubMedCentral: PMC11706009URNIsPartOfWOS: 001391565500001DOIIsPartOf10.1186/s12913-024-12033-52025-05-20T21:21:34Z2025-122025-12-01T00:00:00ZHandlehttp://hdl.handle.net/10362/183246http://purl.org/coar/access_right/c_abf2open accessOverprescribingPatternsPrivateProton-pump inhibitorsPublicRational prescribingHealth PolicySDG 3 - Good Health and Well-being1262767 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://run.unl.pt/bitstreams/390bd578-88df-4d44-bdad-12875409fc94/download |
| spellingShingle | Patterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health system Romano, Sónia Overprescribing Patterns Private Proton-pump inhibitors Public Rational prescribing Health Policy SDG 3 - Good Health and Well-being |
| status | SINGLETON |
| subject.fl_str_mv | Overprescribing Patterns Private Proton-pump inhibitors Public Rational prescribing Health Policy SDG 3 - Good Health and Well-being |
| title | Patterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health system |
| title_full | Patterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health system |
| title_fullStr | Patterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health system |
| title_full_unstemmed | Patterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health system |
| title_short | Patterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health system |
| title_sort | Patterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health system |
| topic | Overprescribing Patterns Private Proton-pump inhibitors Public Rational prescribing Health Policy SDG 3 - Good Health and Well-being |
| topic_facet | Overprescribing Patterns Private Proton-pump inhibitors Public Rational prescribing Health Policy SDG 3 - Good Health and Well-being |
| url | http://hdl.handle.net/10362/183246 |
| visible | 1 |