Anti-reflux and heartburn prescriptions

Medicare spending on anti reflux and heartburn prescriptions is enormous. A recent Wall Street Journal article reported that Nexium was the single most costly drug in terms of overall cost. At first glance the numbers are mindboggling.   There were 8,192,362 prescription claims for Nexium in 2013 for Medicare.

Omeprazole another proton pump inhibitor came in second place for this class of drugs with 6,381,404 prescriptions being filled.  Some articles have stated up to 2.5 billion dollars in cost for medicare patients alone.  Keep in mind that Medicare covers about 50 million patients in the United States but nearly 200 million have private health insurance so the overall number of prescriptions written for proton pump inhibitors is mind numbing.  The actual amount of money spent on these drugs can be hard to track due to discounts from the manufacturers but the number of prescriptions written  is enormous. It these drugs are so popular are patients getting enough relief relative to the amount of money being spent?

Chronic disease with high prevalence and cost

>20 million patients in the US suffer daily from GERDHospitalizations with a diagnosis of GERD  and it increased by 216% between 1998 and 20051

The cost of GERD to U.S. employers is up to $75 billion per year2

Life-long debilitating symptoms; incidence and progression all increasing

Unmet clinical problem

35-40% of patients continue to experience symptoms while on PPIs3

In summary, suffering from reflux and GERD related issues is a common problem in the United States. Unfortunately medical management with lifestyle adjustments and medications do not satisfy the needs of many people who are suffering. The application of surgical management in this disease should not be thought of as a “last resort” but simply one of the options.

The entire spectrum of options for GERD is available to patients at the Virginia Hernia and Heartburn Institute because every patient is different. The combination of different symptoms, anatomy and pathology in each patient does not allow for a “one size fits all” mentality – or a “one pill fits all “approach either. Each patient is unique and the therapy applied is calibrated to his or her particular scenario.

  • 1HCUP Healthcare Cost and Utilization Project (HCUP). January 2008. U.S. Agency for Healthcare Research and Quality
  • 2Wahlqvist P, Reilly MC, Barkun A. Systematic review: the impact of gastro-oesophageal reflux disease on work productivity.Aliment Pharmacol Ther 2006; 24: 259-72
  • 3GERD Patient Study: Patients and Their Medications (AGA Institute)
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