Objective: To determine the dosing equivalents and cost effectiveness of la
nsoprazole versus omeprazole in maintenance therapy of gastroesophageal ref
lux disease (GERD).
Study Design: Single-blind, randomized, crossover study.
Patients and Methods: After completing a 1-week washout period, 27 outpatie
nts (mean age, 66 years) with documented GERD were randomly assigned to rec
eive omeprazole 20 mg or lansoprazole 15 mg daily for 2 weeks. The dosages
were then increased to omeprazole 40 mg or lansoprazole 30 mg daily for an
additional 2 weeks. All patients completed a second 1-week washout period b
efore crossing over to the alternate agent. Patients recorded GERD-related
symptoms (heartburn, chest pain, and regurgitation) daily in a diary. The t
otal symptom score (the sum of the 3 individual symptom scores) were compar
ed for all treatments. Cost effectiveness was evaluated by determining the
cost per percent reduction in the total symptom score.
Results: All treatment groups had significant reductions from baseline in t
he total symptom score (P < 0.01), No significant difference was seen betwe
en lansoprazole 15-mg and omeprazole 20-mg groups or the the lansoprazole 3
0-mg and omeprazole 40-mg groups. Lansoprazole 15 mg was found to be as eff
ective as omeprazole 40 mg and omeprazole 20 mg was as effective as lansopr
azole 30 mg. The average cost per percent reduction in total symptom score
was $0.03 for the lansoprazole 15-mg, lansoprazole 30-mg, and omeprazole 20
-mg doses and $0.05 for the omeprazole 40-mg dose.
Conclusion: Lansoprazole is as effective as omeprazole in providing symptom
atic relief of GERD, Based on acquisition cost, lansoprazole is more cost e
ffective than omeprazole.