The purpose of this study was to assess how gastroenterologists use over-the-counter (OTC) and prescription medications to treat gastroesophageal reflux disease (GERD) and chronic constipation (CC) in their patients. This study included a total of 3,600 randomly selected American Gastroenterological Association (AGA) members who were mailed a 27-question survey that assessed their perceptions and use of OTC and prescription medications. A total of 830 gastroenterologists (23.1%) completed the survey.
The results of the study are as follows: For a typical patient with acid reflux, 50% of gastroenterologists recommended OTC proton pump inhibitors (PPIs), 13% recommended an OTC histamine-2 receptor antagonist, and 33% recommended a prescription PPI. In a typical CC patient, 97% of gastroenterologists initially utilized OTC treatments. The vast majority of gastroenterologists felt that OTC brand name and store brand PPIs (76%) and polyethylene glycol (90%) were equally effective. Despite these statistics, very few gastroenterologists “always” or “very often” directed their patients to purchase a store brand PPI (35%) or laxative (40%). In addition, gastroenterologists tended to underestimate the cost savings associated with store brand medicines and had limited knowledge regarding the regulation of store brands.
The results of this study reveal 2 main points: 1) Among US gastroenterologists, OTC medications now dominate the primary therapy for GERD and CC; 2) Despite feeling that name brand and store brand PPIs and laxatives are equally effective, the majority of gastroenterologists recommend brand name medicines and underestimate the cost savings associated with store brands. The results of this study are pertinent to pharmacy practice. Community pharmacists can play an important role in helping patients save money by explaining that store brand OTC medications are usually just as effective as name brand medications. Since pharmacists are medication experts, it is our job to look out for additional factors that come along with using medications such as cost. The cost of medications can pose as a burden to many patients, and affordability is part of the larger picture when we assess medication adherence and access to medications. This study shows that many patients are not recommended to take non-name brand OTCs in many cases, but we could play a role in fixing this situation by explaining that store brand generics are the same medications as the name brand medications.
My question posed to colleagues: What role do you think pharmacists can play in helping patients save money on medications, especially in the case of store brand vs. name brand OTCs as highlighted in this study? Do you think it’s important that pharmacists help patients save money on their medications, or do you think that should not be part of our jobs?