The UK's NHS spends £100 mln stg a year unnecessarily on proton pump inhibitors such as esomeprazole, the active ingredient of AstraZeneca's biggest-selling product Nexium, as a treatment for indigestion, according to an editorial in the British Medical Journal published tomorrow.
The editorial article, written by Ian Forgacs and Aathavan Loganayagam from King's College Hospital, London, says that over-prescribing proton pump inhibitors is expensive and not evidence-based.
They estimate that worldwide £2bln stg is being spent unnecessarily on proton pump inhibitors.
The BMJ editorial says that in many cases expensive proton pump inhibitors are unnecessary as less-expensive alternative drugs, such as H2 receptor antagonists, are available for many patients. It says that many doctors are not following guidelines published by the UK healthcare spending watchdog the National Institute for Health and Clinical Excellence (NICE).
"If prescriptions were restricted to the recommended indications, expenditure on proton pump inhibitors would be far less than 90 pct of the total dyspepsia drug budget," the report said. "The adverse effect of over-prescription on drug budgets around the world is the real problem. Quite how to motivate doctors to follow guidelines is a matter of considerable importance," the report says.