Condra L J, Morreale A P, Stolley S N, Marcus D
Department of Pharmacy, Veteran Affairs San Diego Healthcare System, CA 92161, USA.
Am J Manag Care. 1999 May;5(5):631-8.
To determine if patients perceived a difference in the efficacy, side effects, and value of omeprazole versus lansoprazole for gastroesophageal reflux disease (GERD) maintenance therapy after a formulary conversion, and to evaluate the costs of the conversion.
An unblinded questionnaire was mailed to patients who were currently receiving GERD maintenance therapy with lansoprazole from the Veterans Affairs San Diego Healthcare System.
Three hundred patients who had been on omeprazole for a minimum of 2 months prior to the formulary conversion and on lansoprazole for a minimum of 2 months after the formulary conversion were surveyed. Patients were asked to rate the severity and frequency of their symptoms (pain, heartburn, and regurgitation) on a scale from 0 to 9 for each medication. Questions regarding side effects, medication preference, and satisfaction with the formulary conversion process were also addressed.
Fifty-two percent of the surveys were returned. There was no statistically significant difference between median total symptom scores for omeprazole and lansoprazole (1.33 vs. 1.34, respectively). More patients reported side effects to lansoprazole (P < 0.001) than to omeprazole. Sixty-four percent of patients preferred omeprazole (P < 0.005). The formulary conversion was estimated to save $29,000 per year.
Omeprazole was the medication preferred by patients for GERD maintenance therapy. Patients were willing to pay an additional fee for their preferred agent. Fewer adverse events were reported with omeprazole. The potential cost savings of the formulary conversion may have been at the expense of patient satisfaction.
确定在医保药品目录转换后,患者是否察觉到奥美拉唑与兰索拉唑用于胃食管反流病(GERD)维持治疗时在疗效、副作用及价值方面存在差异,并评估转换的成本。
向正在接受美国退伍军人事务部圣地亚哥医疗保健系统兰索拉唑GERD维持治疗的患者邮寄了一份非盲调查问卷。
对300名在医保药品目录转换前至少服用2个月奥美拉唑且在转换后至少服用2个月兰索拉唑的患者进行了调查。要求患者针对每种药物,在0至9的量表上对其症状(疼痛、烧心和反流)的严重程度及频率进行评分。还询问了有关副作用、药物偏好以及对医保药品目录转换过程满意度的问题。
52%的调查问卷被收回。奥美拉唑和兰索拉唑的总症状评分中位数之间无统计学显著差异(分别为1.33和1.34)。报告兰索拉唑副作用的患者比报告奥美拉唑副作用的患者更多(P < 0.001)。64%的患者更喜欢奥美拉唑(P < 0.005)。估计医保药品目录转换每年可节省29,000美元。
奥美拉唑是患者用于GERD维持治疗的首选药物。患者愿意为其首选药物支付额外费用。奥美拉唑报告的不良事件较少。医保药品目录转换可能节省的潜在成本可能是以患者满意度为代价的。