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PPI Frequently Asked Questions

Q1: Why didn’t I receive a PPI portrait?

A1: EQIP portraits are distributed using a designed delay process; prescribing portraits are mailed to participating physicians in the Early Group and after a delay of approximately 1 year to the Delayed Group if the intervention in the Early Group shows a significant impact. If you did not receive a portrait, you may be in the Delayed Group. Physicians in the Early Group must have also satisfied all of the following criteria to be eligible to receive a PPI portrait:

  1. Prescribe a PPI to 3 or more patients during the study period
  2. Be defined as a General Practitioner by the BC Medical Services Plan
  3. Have a License Status equal to Private Practice according to the BC Medical Service Plan
  4. Not be retired by 2009 (Fee for Service payments > $0 in the first quarter of 2009)
  5. Must have a valid encrypted identifier in both the Medical Services Plan and Pharmaceutical Services Division databases at the Ministry of Health Services

Q2: Can patients be counted more than once?

A2: Yes. The two bar charts on page 2 count distinct episodes of drug therapy, patients can have multiple episodes of drug therapy. Patients are also counted more than once in the cost tables if they have taken more than one drug product.

Q3: Why would the total cost of my prescriptions be disproportionate to the typical daily treatment cost?

A3: The column “Total Cost of Your Prescriptions” represents the actual ingredient cost of prescriptions for your patients during the study period. It does not account for duration of therapy or product availability, which may vary considerably between drug products you have prescribed.

Q4: Why do the percentages in the bar chart “Your Patients Who Reduced Their PPI Use” add up to more than 100%?

A4: The five categories on the horizontal axis are not mutually exclusive and therefore will not necessarily add to 100%. For example, a patient can switch to a less costly PPI, switch to an H2RA, and stop therapy all in a single episode of PPI therapy.

Q5: How were the evidence-based practice figures calculated?

A5: The evidence-based practice figures are based on real data from BC physicians. Within each of the five categories the prevalence of each possible value [1-100] is calculated. The physician value at the 75th percentile is used as the evidence based target value, with the exception of the “Maintained Dose/Frequency” category, where the 25th percentile value is used.

Q6: Why does the distinct number of PPI patients in the cost table seem inconsistent with the total number of PPI patients in the top bar graph?

A6: The cost tables show counts of patients whereas the graphs on page 2 represent episodes of drug therapy. Since a patient can have more than one episode of drug therapy the total counts may differ.

Q7: I notice that generic ranitidine is more expensive than the brand name. Is this correct? Does this mean I should be prescribing the brand name rather than the generic?

A7: The prices are correct. You should not need to specifically prescribe the brand name. If you prescribe ranitidine, the pharmacist can choose the brand. They should be aware of, and choose, the brand that is in the patient's best interest (for all drugs - not just ranitidine). There is no need for you to keep track of any special cases - just make a habit of prescribing by the drug name rather than brand.