Cost-Effectiveness Analysis: Stress Ulcer Bleeding Prophylaxis with Proton Pump Inhibitors, H2 Receptor Antagonists

Abstract

PPI prophylaxis is the most efficient prophylactic strategy in patients at high risk of developing SUB when compared with using H2RAs.

Ongoing activities to influence the prescribing of proton pump inhibitors within the Scottish National Health Service: their effect and implications

“…For instance, up to 10% of general practitioner (GP) consultations in the UK are for dyspepsia (6). The prescribing of PPIs has increased in recent years with studies showing them to be more effective than H2 antagonists in both preventing and healing ulcers as well as reducing GI bleeds (7)(8)(9)(10)(11)(12)(13). This is important if patients are on long term treatment such as NSAIDs for pain or a combination of antiplatelet and anti-coagulant treatment (14)(15)(16).…”

Proton Pump Inhibitors for Stress Ulcer Bleeding Prophylaxis in Critically Ill Patients: A Cost Analysis Study

“…SUP is most often used for stress-induced ulcer bleeding prevention, e.g., stomach acid neutralizer (antacid), proton pump inhibitor (PPI), histamine-2 receptor antagonist, sucralfate, and misoprostol. The previous studies were conducted by Harty and Ancha [6], Schupp et al [7], Barkun et al [8], and Barletta and Sclar [9] proved that PPI was more effective among all prophylactic agents in preventing stress ulcer bleeding.…”

Stress ulcer prophylaxis in the intensive care unit

“…PPIs and H2RAs present different pharmacological efficacies in preventing stress ulcer bleeding in the ICU. One study found that the probabilities of stress ulcer bleeding and ventilator‐assisted pneumonia were 1.3% and 10.3%, respectively, for PPIs versus 6.6% and 10.3%, respectively, for H2RAs [7]. In one systematic review and meta‐analysis of 1720 patients admitted to ICUs, PPIs were more effective than H2RAs at reducing overt UGIB (relative risk, 0.35; 95% confidence interval, 0.21–0.59; p < 0.0001; I = 15%).…”