Patterns of Esomeprazole Injection Use in Mahasarakham Hospital

Abstract

Introduction: Reports of non-essential drug utilization in Thailand indicate that proton pump inhibitor is one of the top five high expenditure drugs and Esomeprazole is the third highest expenditure non-essential drug in Mahasarakham hospital. Materials and Method: A retrospective review of medical electronic records was conducted in patients receiving Esomeprazole injection during April to June, 2012 in Mahasarakham hospital. Esomeprazole injection use was evaluated in accordance with evidence-based medicine in terms of indication, dose and duration. Cost-saving was estimated drug costs of year 2012. Descriptive statistics was applied for data analysis. Results: Among 219 uses of Esomeprazole injection, most of them were used for upper gastrointestinal bleeding (81.7%), at dose 40 mg continuous IV drip q 4 hr. (high dose) (66.6%), on average of 4.1 ± 4.0 days (range 1 - 27 days). Proportion of the use in accordance with EBM criteria was 89.0%,  79.9%, 72.1% and 62.6% for indication, dose, duration and overall, respectively. In three months, 3,750 vials (1,323,750 baht) of Esomeprazole injection were used where 1,299 vials (458,547 baht) out of them were irrational use according with EBM criteria. If the irrational use would be substituted by Esomeprazole low dose or Omeprazole, medical cost would decline by 401,323 baht/three months or 1,605,292 baht/year. Conclusion: The findings of this study illustrate that most of Esomeprazole injection use in the hospital are in accordance with EBM. However, it is important to improve the use of Esomeprazole injection which will also reduce hospital expenditure.