Digestion Drug: Why so many people take it, and so few need it

Every year doctors write out £7bn (US$13.9bn) worth of prescriptions for a drug group that’s designed to treat stomach acid and other digestion problems. And in up to 70 per cent of cases they’re wrong to do so.

The beneficiary of this inappropriate largesse is a class of drugs known as proton pump inhibitors, and especially one called Losec (omeprazole).

So why do they do it? In most cases it’s prescribed as a ‘just-in-case’ add-on to the laundry list of drugs the patient is already taking. And, according to leading gastroenterologist Ian Forgacs, it’s done because the drug is thought to be benign – unlike most every drug, it doesn’t seem to have many side effects – and because it sort of works some of the time.

But at least £2bn of the drugs shouldn’t be prescribed each year, and the figure is likely to be much higher.

This over-prescribing was illustrated by one study that tracked patients in a hospital in Michigan. Around 20 per cent of the patients were taking a proton pump inhibitor when they were admitted to the hospital – and so were probably taking it for good health reasons. By the end, 90 per cent of the group was taking the drug.

In an editorial, Forgacs, of King’s College Hospital in London, says the drug may not be as benign as doctors believe. The drug group may be playing a part in increased cases of pneumonia, and it may also be doubling the risk of hospital-acquired infections such as C. difficile.

(Source: British Medical Journal, 2008; 336: 2).