National trends in prescription proton pump inhibitor use and expenditure in the United States in 2002-2017

Abstract Objectives In the United States, proton pump inhibitors (PPIs) are one of the most commonly prescribed classes of drugs, but contemporary data on national-level utilization patterns for PPI use are limited. This study examined the trends in prescription PPI use and expenditures, overall and by patient subgroups, and identified predictors of PPI use. Methods Prescription PPI use was identified from the 2002-2017 Medical Expenditure Panel Survey data using the brand and generic names. Trends in PPI use were examined overall and by patients’ sociodemographic characteristics and disease status. Trends in brand and generic PPI users and total and average PPI expenditures were also examined. A multivariable model was used to identify patient factors associated with PPI use. Results The overall proportion of PPI users increased from 5.70% in 2002-2003 to 6.73% in 2016-2017 (P value = 0.011). Increased trends in PPI use were observed among U.S. adults aged 65 years and older, both males and females, non-Hispanic whites, non-Hispanic blacks, Hispanics, Asians, in all 4 geographic regions, with public health insurance, and those who were obese (all P value Conclusion Increased PPI use was observed among most of the patient subgroups. Understanding the utilization patterns of PPIs could help practitioners identify potential treatment disparities and monitor the safety of PPI use.