A recent study published in JAMA Network Open highlights potential savings for hospitals through the routine use of a low-cost drug, pantoprazole. Priced at around 50 cents per dose, this medication not only reduces life-threatening complications in critically ill patients but also demonstrates considerable economic benefits. Researchers from McMaster University led the study, which focused on patients in intensive care units (ICUs) who are mechanically ventilated.
Pantoprazole, a proton pump inhibitor, is used to prevent upper gastrointestinal bleeding in patients at high risk due to invasive mechanical ventilation. These patients often develop stress-related stomach ulcers, leading to bleeding, longer hospital stays, and increased healthcare costs. The findings indicate that administering pantoprazole routinely can help mitigate these issues and significantly lower hospital expenses.
Study Details and Findings
The analysis was conducted alongside data from the REVISE (Re-evaluating the Inhibition of Stress Erosions) trial, which included 4,821 critically ill adults across 68 ICUs in countries such as the United States, Australia, Brazil, Canada, England, Kuwait, Pakistan, and Saudi Arabia. Participants had a mean age of 58 years, with 36 percent identifying as female. The trial compared two patient groups: one receiving daily intravenous pantoprazole and another that did not.
Researchers tracked patient outcomes from ICU admission through to hospital discharge, utilizing a public health care payer’s perspective. The results showed that patients treated with pantoprazole had slightly shorter ICU and hospital stays. Specifically, the average ICU stay was 12.4 days for those receiving pantoprazole, compared to 13.3 days for those who did not. Hospital stays averaged 14.8 days for pantoprazole patients against 16.5 days for others.
Moreover, the study found a substantial difference in treatment costs. The mean total cost per patient treated with pantoprazole was $60,466, compared to $65,423 for those not receiving the drug, resulting in an average savings of $4,957 per patient. In a vast majority of simulation models—99 percent—pantoprazole emerged as both more effective and less expensive.
Implications for Healthcare Systems
The economic benefits of pantoprazole became even more pronounced when applying U.S.-based costs across the entire patient population in a sensitivity analysis. Under this model, the average cost per patient treated with pantoprazole was $130,179, while those not treated incurred costs of $140,770, yielding savings of $10,591 per patient. Even after excluding the top 10 percent of high-cost patients based on ICU days and total expenditures, the pantoprazole treatment group still exhibited savings ranging from $1,151 to $3,388 per patient, depending on the variable examined.
These findings carry significant implications for hospitals and health systems facing resource constraints. By demonstrating that pantoprazole not only offers medical effectiveness but also financial advantages, the study advocates for broader adoption of routine pantoprazole administration for mechanically ventilated ICU patients. Previously, the economic value of pantoprazole in this context had not been clearly established, but this research provides robust evidence for clinicians, pharmacy departments, and policymakers to consider.
As hospitals continue to navigate financial challenges, integrating cost-effective treatments like pantoprazole could become a critical strategy for improving patient care while managing expenses. The study’s findings are expected to influence future guidelines and practices in intensive care settings, underscoring the importance of both clinical and economic considerations in patient management.
