John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Proton-pump inhibitors: why are good practice guidelines needed? Volume 23, issue 6, Juin 2016

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Author
Centre Hospitalier de Marne-la-Vallée,
service d’hépato-gastro-entérologie,
2-4 cours de la Gondoire,
77 600 Jossigny,
France
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Proton pump inhibitor's (PPI) are one of the most prescribed therapeutic classes and represent the third most expensive therapeutic class for the French public health insurance system. The advent of generic molecules in 2004, then of over-the-counter drugs in 2008, has contributed to a decrease in the costs of IPP. General practitioners are responsible for 90% of prescriptions. The respect of the marketing authorizations, of relevant indications outside marketing authorizations and non-indications of PPIs, are central to the economic stakes of this therapeutic class. The rates of inappropriate prescription range from 25 to and 70% according to the literature. Serious adverse effects associated with PPIs are rare, but not tolerable in patients not treated for correct indications. There is also an under-prescription of PPIs, especially in co prescription with NSAIDs. Therefore, it seems important to review the indications and non-indications, the doses and durations of treatment, the side effects of PPIs, to optimize their prescription.