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Original Article
- Utilization of Acid Suppressants After Withdrawal of Ranitidine in Korea: An Interrupted Time Series Analysis
- Jeong Pil Choi, Sangwan Kim, Jung Su Park, Mi-Sook Kim, Nam-Kyong Choi, Cheol Min Shin, Joongyub Lee
- J Prev Med Public Health. 2025;58(1):21-30. Published online December 30, 2024
- DOI: https://doi.org/10.3961/jpmph.24.357
- 12,237 View
- 585 Download
- 3 Web of Science
- 2 Crossref
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Abstract
Summary
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Supplementary Material - Objectives
This study was performed to evaluate the utilization patterns of acid suppressants following the withdrawal of ranitidine in Korea.
Methods
Health Insurance Review & Assessment Service (HIRA) data from January 2016 to May 2023 were utilized to assess the usage of histamine H2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) for acid-related diseases. Drug utilization was calculated for each agent based on the defined daily dose (DDD). To evaluate changes in utilization following the ranitidine recall, an interrupted time series analysis was conducted using segmented linear regression and an autoregressive integrated moving average model.
Results
Before the withdrawal of ranitidine, the DDD per 100 000 inhabitants per day was increasing by 6.9 (95% confidence interval [CI], 4.7 to 9.0) for H2RAs and by 19.3 (95% CI, 16.9 to 21.8) for PPIs each month. After the recall, H2RA utilization immediately declined by -1041.7 (95% CI, -1115.8 to -967.7), followed by a monthly increase of 6.6 (95% CI, 3.7 to 9.6) above the previous trend. PPI utilization temporarily surged by 235.2 (95% CI, 149.1 to 321.3), then displayed a monthly increase of 4.1 (95% CI, 0.7 to 7.6) on top of the pre-recall trend. Among PPIs, esomeprazole and rabeprazole demonstrated notable increases, representing the most commonly used acid suppressants in 2023.
Conclusions
PPI usage rose prominently following the withdrawal of ranitidine from the market. Considering the potential adverse effects of PPIs, further research is necessary to evaluate the public health implications of shifts in the utilization of acid suppressants. -
SummaryKorean summary
- 위산분비억제제의 국내 사용량은 양성자 펌프 억제제를 중심으로 지속적으로 증가하고 있으며, 라니티딘이 시장에서 퇴출된 이후 더욱 급격히 증가하는 양상이 관찰되었다. - 양성자 펌프 억제제 사용 증가와 관련해 장기 복용의 안전성, 처방의 적절성, 잠재적 오남용의 가능성, 비용효과성의 측면에서의 보건학적 의의에 대한 평가가 필요하다.Key Message
- The use of gastric acid suppressive drugs in Korea has demonstrated a consistent upward trend, with proton pump inhibitors (PPIs) predominating, especially following the withdrawal of ranitidine from the market. - The escalating utilization of PPIs necessitates a comprehensive evaluation of their public health implications, encompassing the long-term safety, appropriateness of prescribing, potential overuse, and cost-effectiveness. -
Citations
Citations to this article as recorded by
- Prenatal Exposure to Acid-Suppressive Medications and Risk of Neuropsychiatric Disorders in Children
Seohyun Hong, Sooji Lee, Hyunjee Kim, Hyesu Jo, Kyeongmin Lee, Yeona Jo, Tae Hyeon Kim, Jaeyu Park, Jinseok Lee, Ho Geol Woo, Hayeon Lee, Dong Keon Yon
JAMA.2026; 335(7): 609. CrossRef - Proton Pump Inhibitors (PPIs)—An Evidence-Based Review of Indications, Efficacy, Harms, and Deprescribing
Monica Andrawes, Wessam Andrawes, Abhishek Das, Keith Siau
Medicina.2025; 61(9): 1569. CrossRef
- Prenatal Exposure to Acid-Suppressive Medications and Risk of Neuropsychiatric Disorders in Children
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