The prevalence of GERD or Gastroesophageal Reflux Disease among Filipinos has significantly increased over the last decade, according to a study done by the Endoscopy Unit of the University of Santo Tomas (UST) Hospital in Manila.
GERD, also known as acid reflux disease, happens when acid from the stomach flows back up into the esophagus causing a burning sensation called heartburn. Heartburn occasionally happens to most people, but if it happens two or more days a week for at least three months, the person may already have GERD. If not treated, it can lead to more serious health issues.
According to the UST study “Erosive esophagitis in the Philippines: A comparison between two time periods” published in the Journal of Gastroenterology and Hepatology, prevalence of GERD was significantly higher in 2000-2003 than in 1994-1997. The study also notes that in Asia, the incidence of GERD diagnosed through endoscopy has increased from 3-9 percent to 14-16 percent in a similar period.
Currently, the best way to manage GERD is by treatment with Proton Pump Inhibitor (PPI) medication. PPI works by completely blocking the production of stomach acid that may cause heartburn. PPI drugs available in the market are omeprazole, lansoprazole, pantoprazole, reberprazole, and esomeprazole. The recent US study “Formulary Management of PPIs” published in PharmacoEconomics Journal revealed that the mechanisms of these PPIs currently available are very similar and are thus, all effective in GERD treatment.
Another study, “All PPIs equivalent for GERD treatment” published in the American Family Physician in January 2006 by Dr. Mark Ebell, also revealed that “there is no significant difference between equivalent doses of PPIs, including equivalent doses of esomeprazole and omeprazole.” The study thus recommends that “the decision to choose one PPI over another should be based first on cost and second on individual patient response.”
In the Philippines, however, most PPI drugs have prohibitive prices and are thus, out of reach for many Filipino patients. Government data shows only two percent of a Filipino family’s monthly budget goes to healthcare, a measly part of which is for purchase of medicines. Given the current prohibitive costs of many PPI drugs, a half-month treatment will already consume about 15 percent of a family’s monthly income. Hence, under these circumstances, it is more likely that GERD patients will either discontinue treatment or forego treatment altogether.
While affordable generic PPI drugs are available in the market, patients are advised to consult with their doctors in choosing the most cost-efficient generic PPI drug that is manufactured by a highly reputable pharmaceutical company trusted for its quality healthcare, and that has been proven safe and effective by bioequivalence studies. Bioequivalence is the internationally and scientifically accepted way of determining if two different drugs have the same therapeutic effect.
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