Managed Healthcare Executive - December 2008 - (Page 27)

Some Drugs for Peptic Ulcers/GERD Drug Proton-Pump Inhibitors Esomeprazole – Nexium (AstraZeneca) Lansoprazole – Prevacid (TAP) Omeprazole – generic Prilosec (AstraZeneca) Prilosec OTC generic Zegerid Pantoprazole – Protonix (Wyeth) Rabeprazole – Aciphex (Janssen) H2-Receptor Blockers Cimetidine – generic Tagamet (GlaxoSmithKline) Tagamet HB (OTC) generic Famotidine – generic Pepcid (Merck) Pepcid AC (OTC) generic Pepcid Complete (OTC) Nizatidine – generic Axid (Lilly) Axid AR (OTC) Ranitidine – generic Zantac (GlaxoSmithKline) Zantac (OTC) generic Other Drugs Misoprostol2 – generic Cytotec (Searle) Sucralfate – generic Carafate (Aventis) Dosage Tablet/Capsule Size Cost1 20-40 mg once daily 15-30 mg once daily 20-40 mg once daily 20, 40 mg caps 15, 30 mg tabs, ODT 10, 20, 40 mg caps 20 mg tabs 20, 40 mg caps 20, 40 mg tabs 20 mg tabs 20-40 mg once daily 20 mg once daily $166.20 167.70 98.70 148.50 21.30 17.16 150.60 127.20 167.40 200-400 mg bid 200, 300, 400, 800 mg tabs 200 mg tabs 10-20 mg bid 20, 40 mg tabs 10, 20 mg tabs 10-20 mg once daily 75-150 mg bid 75-150 mg bid 10 mg chew tabs 150, 300 mg caps 150, 300 mg caps 75 mg 150, 300 mg tabs, caps 150, 300 mg tabs 75, 150 mg 82.20 140.40 34.80 14.39 99.60 112.20 21.00 5.29 10.80 114.60 188.40 36.00 87.00 198.00 38.40 15.22 200 mcg bid-tid•2 1 g qid 100, 200 mcg tabs 1 g tabs 61.20 103.80 69.60 160.80 OTC = Over the counter; ODT = orally disintegrating tabs. 1. Cost for 30 days’ treatment at the lowest dosage used for treatment of peptic ulcers, according to recent data (May 31, 2008) from retail pharmacies nationwide available from Wolter’s Kluwer Health. Generic OTC prices are from drugstore.com or cvs.com (accessed July 14, 2008). 2. FDA-approved only for prevention of NSAID-associated gastric ulcers. Source: Treatment Guidelines from The Medical Letter, Vol. 6 (72) August 2008 Dr. Edison uses a variety of educational materials on treatments for ulcers and H. pylori, and on preventing peptic ulcer disease. “In our population, the most important preventive measure is avoiding, if possible, non-steroidal anti-in ammatory drugs,” he says. In addition, A nity advocates lifestyle changes. Being overweight is a major contributing factor to re ux disease. Counseling emphasizes dietary triggers for re ux disease. Patients are urged to cut out chocolate, fried foods, peppermints, and ca einated or carbonated beverages, and to limit alcohol, avoid tobacco, and avoid late-night eating. “Prilosec is a very e ective medication with few side e ects, and the generic version available over the counter works well,” Dr. Edison says. “But you really need to couple medications with lifestyle changes.” MHE This article is based on information supplied by The Medical Letter (www.medicalletter. org), a non-pro t organization that publishes newsletters o ering critical appraisals of new drugs and comparative reviews of older drugs. The Medical Letter is completely independent of the pharmaceutical industry. It is supported entirely by subscription sales and accepts no advertising, grants or donations. Institutional site license inquiries can be sent to info@medicalletter.org. DECEMBER 2008 27 http://www.drugstore.com http://www.cvs.com http://www.medicalletter.org http://www.medicalletter.org

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Managed Healthcare Executive - December 2008

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