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Patterns of outpatient proton‒pump inhibitors use among older adults in a duplicative health system

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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

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