Impact of a formulary change in proton pump inhibitors on health care costs and patients' symptoms

Patients may fail to successfully undergo a switch in therapy associated wi th a formulary change. The aim of this study was to measure health carl cos ts and outcomes among patients who failed a formulary change in proton pump inhibitors in a VA medical center. Patients who failed a switch from omepr azole to lansoprazole (N = 51) were matched with patients who were successf ully switched (N = 51). Health care utilization data was gathered from VA e lectronic databases and medical records for six months before and after the switch and, for failure patients, during the lansoprazole trial period. St atistical comparisons between failure and success patients were performed o n changes in health care costs between these time periods. Health outcome d ata for the lansoprazole trial period and subsequent omeprazole reinstateme nt period were obtained through a telephone questionnaire of failure patien ts. Changes in total health care utilization costs did not differ significa ntly between failure and success groups for any of the time periods. Failur e patients had significantly poorer health outcomes during their lansoprazo le trial periods with significantly greater severity of heartburn and sever ity and frequency of acid regurgitation (P < 0.001). In conclusion, the for mulary change had a negative impact upon health outcomes among failure pati ents but did not significantly affect their health care utilization costs. Identification of failure patients early in their lansoprazole trial period s could improved their health outcomes and satisfaction with medical care.