Surveillance of Some Recent Proton Pump Inhibitors

by Shrivastava S*., Dwivedi S., Kapoor S., Dubey D., Dubey P. K, Sonaniya R.,

The present paper through the light on the marketing survey of PPIs and a comparison of drugs, having less drug-drug interaction and adverse drug reaction which benefits the patient’s compliance towards the use PPIs.  Market research of PPIs was carried from July 2006 to August 2006; datas were collected from five hospitals and fifteen chemist of Indore city. Datas revealed that market share of Pentoprozole i.v. is 70% (Pentodac i.v. with 48%), Rabeprazole i.v. is 22% (Rabeloc i.v. with 75%) and Omeoprazole i.v. is 8% (Ocid i.v. with 75%). 

ABSTRACT

From the time proton pump inhibitors (PPIs) have been available for the treatment of gastrointestinal acid secretary disorders, they have been dramatically altered the management of common disorders. Evidence obtained from several well-designed clinical trials indicates that i.v. PPIs has more potent anti-secretary effect as compared to their oral counterparts. Market research of PPIs has carried from July 2006 to August 2006; datas were collected from five hospitals and fifteen chemist of Indore city. Datas revealed that market share of Pentoprozole i.v. is 70% (Pentodac i.v. with 48%), Rabeprazole i.v. is 22% (Rabeloc i.v. with 75%) and Omeoprazole i.v. is 8% (Ocid i.v. with 75%). Rabeprazole i.v. is newly emerged drug, growing very fastly due to its high efficacy and safety. It is very effective in bleeding ulcer and also having minimum drug-drug interaction. Further studies showed that although the share of Rabeprazole i.v. is only 22% but its growth is very high, which indicates that in future it may fetch more market share and overwhelm the other PPIs. The present paper through the light on the marketing survey of PPIs and a comparison of drugs, having less drug-drug interaction and adverse drug reaction which benefits the patient’s compliance towards the use PPIs.

 *For Correspondence Shri Rawatpura Sarkar Institute of Pharmacy, Kumhari, Drug (C.G.), 492010, India Tel:  +91-7821-247271, E-mail:  This email address is being protected from spambots. You need JavaScript enabled to view it., This email address is being protected from spambots. You need JavaScript enabled to view it., 

INTRODUCTION

In the hospital setting, prophylactic acid suppression is an important part of care of many critically ill patients. The late 1970’s saw the introduction of histamine 2-receptor antagonist, which is partially, suppress basal and meal stimulated acid secretion, some of these agents can induce intra-gastric pH greater than 3, lasting for approximately 10 hours when given twice per day at recommended doses. This level of acid secretion may be facilitated healing of duodenal ulcers but have limited efficacy for other indications (e.g., gastrointestinal bleeding).

In the late 1980’s a more potent class of acid-suppressing agents PPIs was developed. These can induce an intra gastric PH above three lasting for approximately 17 hours per day and an intra gastric PH above 5 for approximately 9 hours per day after per day oral administration of recommended doses.

The proton pump is an ATP dependent ion pump present in the parietal cell, is protenious in nature and it exports H+ ions from the cytoplasm of parietal cell into the canaculi in exchange for KT ions. PPIs are used for the treatment of gastro intestinal acid secretary disorders1.

STUDY AREA

The present market research of PPIs was carried out in five different hospitals (Bombay Hospital, Bhandari Hospital, Gokuldas Hospital, Shakuntal Hospital & Bafana Hospital) and fifteen chemists (Rohan Chemist, Mantri Medicose, Mehta Chemist, Manohar Brothers, Mahaveer Medicose, Agarwal Chemist, Meera Medicose, Piyush Chemist, New Citizen Chemist, Maya Medicose, Laxmi Chemist, Pooja Medical Store, Subham, Sneh & Saif Medicose), located in different areas of indore, study sites were selected considering the number of patient in the hospital, prescription and sale of PPIs at the chemists.

METHODOLOGY

Different study sites (Five hospitals & Fifteen chemists), scattered over different areas of Indore locality were selected on the basis of number of patient, prescription and sale of drug. The knowledge about the use of drug was obtained both by doctors and chemist. During the course of present market research, all the study sites were visited after carefully planned trip in the months of July 2006 to August 2006. Data regarding the use of the drug were collected as per plan suggested2,3.

OBSERVATIONS

The data collected during market survey give the following information about the feasibility of new products, forecasting of marketing demands, study of competitor activities, study of physician behaviors on prescription drugs and consumers on OTC drugs, capacity of patient to afford drug and need for drug in that category, cultural changes of society and its impact on drug consumption.

The studies show the following facts about market share of PPIs;

·        Pentoprazole i.v. having highest market share of 70% following by Rabeprazole i.v. of 22% and Omeprazole i.v. 8% (Fig 1)

·        Omeprazole brand Ocid i.v. (Zydus Cadila) is having market share of 75%

·        Pentoprazole brand Pentodac i.v. (Zydus Cadila) is enjoying 40% of market share

·        Rabeprazole brand Rabeloc i.v. (Cadila Pharma) is enjoying 75% of market share

Data also revealed the contributions of doctors in prescribing the PPIs for gastrointestinal disorders;

·      Contribution of MD is 52% of total PPIs i.v. followed by 31% of MS and 17% of MBBS (Fig 2, Table 1)

·      In Omeprazole i.v. contribution of MD is 60%, followed by MS 14% and MBBS 26%

·      In Pentoprazole i.v. MD contribution is 48%, followed by MS 36% and MBBS 16%

·      In Rabeprazole i.v. MD contribution 60% followed by MS 22% and then MBBS 18% (Table 2).

·     Market Survey of PPIs in Bhandari Hospital and New Citizen Chemist are shown in table 3 & 4 

RESULT AND CONCLUSION

PPIs have been available for the treatment of gastrointestinal acid secretary disorder, Evidences obtained from several well-designed clinical trials indicates that i.v. PPIs have potent anti-secretary effect as compared to their oral counterparts. Data revealed that market share of Rabeprazole is growing very fastly due to its high efficacy & safety. It is possible to attain even higher pH at larger doses and with continuous i.v. infusion. Thus the above finding indicates that, Rabeprazole i.v. is having lowest share of 22% in market as compared to other PPIs. Though it is a newest drug out of the three PPIs doctors are prescribing it more because of its better pharmacological actions. Rabeprazole is having unique structure properties, which make it more efficacious with minimum drug-drug interaction, adverse drug reactions & toxic effects. So, it is expecting that in future, it may lead over the other PPIs and proved to be an intensive choice for the human health benefits.

ACKNOWLEDGMENT

The authors are thankful to the doctors, pharmacist and chemist for their valuable support and suggestion about the present market research.

REFERENCES 

1.    Tripathi, K.D. “Essential of medical pharmacology, Jaypee publishers, Vth ed. 2005.
2.    Kevin Farmer C, Ashok Gumblirk- Unclaimed prescription: an over looked opportunity. Am. Phar. 1992; 10:55.
3.    Benjamin DM, Reducing medication errors and increasing patient safety: Case studies in Clinical Pharmacology; J. Clin Pharmacology July 2003; 43(7): 768-83.
4.    Ed. Wiltink H. Medication control in hospitals: A practical approach to the problem of drug-drug interaction. Pharm.Word Sci. 1998, 20(4): 175.
5.    Lucian Leape I. et al. Pharmacist participation on physician rounds and reverse drug      events in the intensive care unit. J. Am. Medical Assoc. 1999; 3:267.

Table 1 Doctors contribution for PPIs 

  Table 2 Doctors contributions for Rabeprazole  

Table 3 Market Survey of PPIs in Bhandari Hospital 

          
Table 4 Market Survey of PPIs in New Citizen Chemist