TRICARE, the government health care program for civilian family members of active military personnel, has announced that it will remove the antacid medication Nexium from its formulary drug listing beginning June 28th. After that date, the proton pump inhibitor will no longer be available in military pharmacies and clinics. Patients currently being prescribed Nexium (esomeprazole) are being advised to change their prescriptions to one of three alternatives, i.e., omeprazole (Prilosec, Zegerid), pantoprazole (Protonix) or rabeprazole.
Exceptions will be made for patients whose physicians determine that an alternative is not appropriate and that Nexium is the only effective treatment option. In such cases, TRICARE will continue to cover the cost of the drug, requiring only a modest co-pay. The decision will affect approximately 338,000 patients who obtain health care services through TRICARE.
According to a spokesman for the Department of Defense Health Agency, discontinuing Nexium will save U.S. taxpayers as much as $584 million a year. The Defense Department's preferred pricing agreement, which dates from 2007, ended on April 1st.
Proton pump inhibitor such as Nexium are used in the treatment of gastroesophageal reflux disease, or GERD. This condition is a chronic disease that causes stomach acid to flow up into the esophagus, which can cause serious damage to tissues over time. While changes in lifestyle and diet can often address the problem, a few patients require ongoing medication to control the disease.
Although the Defense Department's primary concern in the removal of Nexium from its preferred drug listing is cost savings, the drug, like other proton pump inhibitors such as Prilosec, has been linked to numerous serious side effects when used over an extended period of time. These side effects include kidney failure, heart attacks, increased risk of stroke, osteoporosis, abdominal fluid build-up (ascites) and early-onset dementia and accelerated aging.
Proton pump inhibitors literally “inhibit,” or prevent, the production of stomach acid. While this is not normally a problem when such medications are used occasionally, numerous studies over the past few years have shown that long-term users not only run the risk of the above-mentioned health problem, they can develop dependency. Current lawsuits against drug makers AstraZeneca and Pfizer allege that the companies were aware of the danger of kidney disease and failed to warn consumers.
Research indicates that between 30 and 70 percent of patients being treated with proton-pump inhibitors have no long term medical need. However, these medications have historically been big sellers for pharmaceutical companies. According to data published by Consumer Reports in 2013, sales of proton-pump inhibitors accounted for $9.5 billion in U.S. sales the previous year. From 2006 until 2016, Nexium was AstraZaneca's top selling product, though revenues from this product have dropped significantly in recent years.