A Pharmacoeconomic Comparison of the Efficacy and Costs of Pantoprazole and Omeprazole for the Treatment of Peptic Ulcer or Gastroesophageal Reflux Disease in the Netherlands Ben A. van Hout, 1 Rogier M. Klok, MSc, 2 Jacobus R.B.J. Brouwers, PhD, 2 and Maarten J. Postma, PhD 2 tDutch Centerfor Health Economics and System Science, Capelle aan de Issel, and 2Groningen University Institute for Drug Exploration and University of Groningen Research Institute of Pharmacy, Groningen, the Netherlands ABSTRACT Background: The focus of treatment of patients with peptic ulcer or gastro- esophageal reflux disease has changed during the last 15 years, with a shift from histamine2-receptor antagonists to proton-pump inhibitors (PPIs). From 1993 to 2000, expenditures for omeprazole (90% of total market share of PPIs) increased in the Netherlands from ¢68 million to ¢230 million. In 1999, expenditures for pantoprazole accounted for the majority of the rest of the market share for PPIs. Objective: The objective of this study was to compare the efficacy and costs of treatment with pantoprazole and omeprazole in the Netherlands. Methods: First, we reviewed clinical studies that compared the efficacy of dif- ferent dosages of omeprazole and pantoprazole. Second, we analyzed data from a nationwide database of drug prescriptions to determine the dosages used in daily practice in 1999. The data were based on a representative sample of -40% of the Dutch community pharmacies. Third, we modeled the outcome of potential sub- stitution of pantoprazole for omeprazole and the corresponding scenarios for na- tionwide cost savings using the prescription information from the nationwide data- base. Potential savings within the Dutch health care system were estimated. Results: The 1999 prescription data indicated that pantoprazole treatment cost a mean ¢1.59/d, compared with ¢2.12ld for omeprazole (¢1.00 = US $1.0487). The mean cost per defined daily dose of omeprazole was ¢1.65, compared with This paper was presented as a poster at the 9th United European Gastroenterology Week, October 6-11, 2001, Amsterdam, the Netherlands. Accepted Jor publication December 5, 2002. Printed in the USA. Reproduction in whole or part is not permitted. 0149-2918/03/$19.00 Copyright © 2003 Excerpta Medica,Inc. 635