A Retrospective Observational Study on Prescription Pattern and Cost Analysis of Proton Pump Inhibitors in a Secondary Healthcare Hospital in Krishnagiri District, Tamil Nadu

Review Article

Abstract

Proton Pump Inhibitors (PPIs) is one of the most frequently utilised classes of pharmacotherapeutic agents globally, indicated for a spectrum of acid-peptic disorders. Despite their efficacy, growing evidence suggests a prevalence of irrational prescribing practices, contributing to escalated healthcare expenditures and potential adverse effects. This study evaluated the utilisation patterns, indication appropriateness, and cost implications of PPI therapy within a secondary healthcare facility in Tamil Nadu, India. A retrospective observational study was conducted involving 100 inpatients prescribed PPIs over a six-month period. Clinical data, including demographics, specific drug selection, route of administration, and indication for therapy, were extracted and analysed alongside a cost-minimisation analysis of available brands. The cohort was predominantly male (63%), with the highest usage frequency observed in the 41–60 age group (49%). Pantoprazole was the most commonly prescribed agent (63%), followed by Esomeprazole (17%) and Rabeprazole (15%). Most importantly, intravenous administration was the preferred route in 63% of cases, suggesting a potential area for rationalising therapy conversion to oral forms. Clinical indications revealed that only 9% of patients were treated for active Peptic Ulcer Disease, while a significant proportion received PPIs for co-morbidities (39%) or analgesic prophylaxis (23%) without clear risk stratification, highlighting a trend of defensive or habitual prescribing. Cost analysis showed significant price variation among brands, with Pantoprazole incurring substantial cumulative costs due to high prescription volume.