Efficacy and cost effectiveness of lansoprazole versus omeprazole in maintenance treatment of symptomatic gastroesophageal reflux disease



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American Journal of Managed Care







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Objective: To determine the dosing equivalents and cost effectiveness of lansoprazole versus omeprazole in maintenance therapy of gastroesophageal reflux disease (GERD).

Study Design: Single-blind, randomized, crossover study.

Patients and Methods: After completing a 1-week washout period, 27 outpatients (mean age, 66 years) with documented GERD were randomly assigned to receive omeprazole 20 mg or lansoprazole 15 mg daily for 2 weeks. The dosages were then increased to omeprazole 40 mg or lansoprazole 30 mg daily for an additional 2 weeks. All patients completed a second 1-week washout period before crossing over to the alternate agent. Patients recorded GERD-related symptoms (heartburn, chest pain, and regurgitation) daily in a diary. The total symptom score (the sum of the 3 individual symptom scores) were compared for all treatments. Cost effectiveness was evaluated by determining the cost per percent reduction in the total symptom score.

Results: All treatment groups had significant reductions from baseline in the total symptom score (P < 0.01), No significant difference was seen between lansoprazole 15-mg and omeprazole 20-mg groups or the the lansoprazole 30-mg and omeprazole 40-mg groups. Lansoprazole 15 mg was found to be as effective as omeprazole 40 mg and omeprazole 20 mg was as effective as lansoprazole 30 mg. The average cost per percent reduction in total symptom score was $0.03 for the lansoprazole 15-mg, lansoprazole 30-mg, and omeprazole 20-mg doses and $0.05 for the omeprazole 40-mg dose.

Conclusion: Lansoprazole is as effective as omeprazole in providing symptomatic relief of GERD, Based on acquisition cost, lansoprazole is more cost effective than omeprazole.

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