Rationale and Objective: Proton pump inhibitor (PPI) is one of the most widely prescribed
medicines and commonly used in gastric related disorders and there is a huge need to analyze
the irrational use of PPI in a country like India. The present study was designed to describe the
rational drug use and cost comparison analysis of PPI in a rural tertiary care hospital.
Methodology: A prospective observational study was performed among 253 inpatients for a period
of 9 months after getting ethical approval. Those who received the PPIs for any of its indications
were included in the study without any gender or age restriction. US FDA guidelines were used to
analyse the appropriateness of the drug use and cost comparison analysis of the branded versus generic
PPIs was also performed.
Findings: Among the 253 inpatients, the majority (62%) were male and the mean age was 46±19
years. Mean hospital stay and the number of drugs in prescription were found to be 4.0 ± 1days 4.39
±1.16 items, respectively. Pantoprazole (76%) was the most prescribed PPI even though the majority
(57%) of the patients treated outside the FDA approved indication. Drug interaction has been reported
in 14% and ADR in 9% of the population. The average cost of hospital stay estimated as
207.96+149.57 INR, and potential cost saving of INR 41582 was observed with generic replacement.
Conclusion: The study inferred irrational drug use of PPI still prevalent, that too without considering the
economic impact of it on general populations. Healthcare practitioners should be aware and cautious
while prescribing the PPI to identify the actual need and to choose the most cost-effective alternative 1.