PHILADELPHIA, Pennsylvania—Proton-pump inhibitor (PPI) gastroprotection would add $234 in medical costs for each elderly NSAID user but would reduce total medical costs by $2019 per person, Veterans Affairs (VA) medical researchers reported at the 2007 American College of Gastroenterology meeting.¹

Neena S. Abraham, MD, and colleagues studied a cohort of 481,495 veterans >e;65 years of age who were prescribed an NSAID or coxib at a VA facility. The researchers pooled data on upper gastrointestinal (GI) events and related endoscopic, radiological, or surgical procedures; ambulatory visits; pharmacy costs; as well as inpatient hospitalization days. Half of the patients with upper GI events require hospitalization.

The data included 293,594 person-years of follow-up, during which 3205 upper GI events occurred. Of these, 36.9% were treated by the VA at a cost of $5.05 million, of which $4.9 million was related to medical resource use.

"[T]he 33.8% prescribed a PPI were less likely to be hospitalized (OR 0.39) and had a lower median total medical cost than those not prescribed a PPI ($522.13 versus $1.26, P <.001)," Dr. Abraham said. "PPI gastroprotection for high-risk elderly patients is associated with fewer NSAID-related upper GI events and reduced hospitalization and associated resource costs. Reduced resource costs offset higher pharmacy-related costs, making PPI gastroprotection beneficial for elderly veterans."

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