Less Is More
May 10, 2010

Failing the Acid TestBenefits of Proton Pump Inhibitors May Not Justify the Risks for Many Users

Author Affiliations

Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Intern Med. 2010;170(9):747-748. doi:10.1001/archinternmed.2010.64

Financial Disclosure: Dr Katz is an independent consultant for Health Management Associates.

A staggering 113.4 million prescriptions for proton pump inhibitors (PPIs) are filled each year, making this class of drugs, at $13.9 billion in sales, the third highest seller in the United States.1 These medications are effective for treatment of erosive and ulcerative esophagitis, Barrett esophagus, Zollinger-Ellison syndrome, and gastroesophageal reflux disease (GERD), as well as for short-term treatment of ulcer disease, as part of a combination regimen for Helicobacter pylori eradication and for prevention of ulcers due to nonsteroidal anti-inflammatory drugs.2 However, these indications do not account for more than a hundred million prescriptions. So it should come as no surprise that PPIs have been shown to be overprescribed3; between 53% and 69% of PPI prescriptions are for inappropriate indications.2,4,5

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