the Regulations on Losec for Chronic Gastric Ulcers

Regarding the medication LOSEC for gastric ulcers?

Hello Dr.
Yang: My father has been receiving treatment for chronic gastric ulcers at Changhua Christian Hospital.
In the first phase, he returned to the hospital for check-ups every two weeks, and the doctor prescribed LOSEC.
After taking it, my father felt that the burning sensation in his stomach and esophagus, as well as the acid reflux, had subsided.
After one month (or four weeks), he returned to the hospital for a check-up and medication, but the doctor did not prescribe LOSEC again and instead substituted it with another medication, providing a four-week supply.
However, after switching medications, my father's stomach began to experience burning sensations and acid reflux again.
When I asked the doctor if he could switch back to the original LOSEC prescription, the doctor stated that the National Health Insurance Administration has regulations that prevent the prescription of this medication again.
If LOSEC is absolutely necessary, my father would have to wait four months after treatment and undergo a re-evaluation of his gastric condition before it could be prescribed again.
Dr.
Yang, is there really such a regulation? Additionally, I noticed that the price of LOSEC is cheaper than the other medication prescribed.
Why would the National Health Insurance Administration have such a regulation? Is it possible that the hospital is trying to profit from this? Do we have any channels for filing a complaint?

SUSAN, 40~49 year old female. Ask Date: 2002/11/11

Dr. Yang Peizhen reply Gastroenterology and Hepatology

Hello! Currently, the National Health Insurance Administration has clear regulations regarding the use of gastric medications for peptic ulcers or gastroesophageal reflux disease (GERD): 1.
Losec (omeprazole) is limited to a maximum of two months if prescribed for gastric ulcers, while other types of gastric medications are relaxed to four months.
2.
Losec is limited to one month for moderate GERD and two months for severe GERD.
Therefore, physicians must adhere to the regulations set by the National Health Insurance Administration and are not prescribing medications indiscriminately for profit.
Wishing you and your family peace and happiness.
Sincerely, Dr.
Yang Pei-Chen, Department of Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2002/11/11

More Info

The situation you described regarding the use of Losec (omeprazole) for chronic gastric ulcers is a common concern among patients and their families. In Taiwan, the National Health Insurance Administration (NHIA) has specific regulations regarding the prescription of proton pump inhibitors (PPIs) like Losec, particularly for conditions such as gastric ulcers and gastroesophageal reflux disease (GERD).
According to the NHIA guidelines, the prescription of Losec for gastric ulcers is indeed limited. If Losec is used for gastric ulcers, it is typically prescribed based on the findings from an endoscopy report that is no older than two months. For other types of gastric medications, the prescription period may be extended to four months. This means that if your father was treated with Losec for his gastric ulcer, the physician is required to follow these guidelines and cannot simply renew the prescription without adhering to the stipulated time frame and conditions.

The rationale behind these regulations is multifaceted. Firstly, it aims to ensure that patients receive appropriate and effective treatment while minimizing the risk of over-prescription of medications that may not be necessary after a certain period. Secondly, it encourages healthcare providers to reassess the patient's condition regularly, ensuring that any changes in symptoms or health status are adequately addressed.
Regarding your observation that Losec is less expensive than the alternative medication prescribed, it is important to note that the NHIA's regulations are not necessarily based on the cost of medications but rather on clinical guidelines and the need for ongoing assessment of the patient's condition. The healthcare system aims to balance cost-effectiveness with the quality of care provided to patients.

If you feel that your father's health is deteriorating due to the change in medication and the return of symptoms, it is crucial to communicate this to his healthcare provider. The physician may consider alternative treatments or adjustments based on your father's current condition. If necessary, a follow-up endoscopy might be warranted to evaluate the status of the gastric ulcer and determine the best course of action.

As for the concern about potential financial motivations behind the prescribing practices, it is essential to understand that healthcare providers are bound by ethical standards and regulations. If you believe that there is a legitimate concern regarding the treatment your father is receiving, you can consider discussing this with the healthcare provider directly or seeking a second opinion from another qualified physician.
In summary, the regulations surrounding the prescription of Losec for chronic gastric ulcers are in place to ensure patient safety and effective treatment. If your father is experiencing a recurrence of symptoms, it is vital to address this with his healthcare provider to explore the best options for his care.

Similar Q&A

Understanding Stomach Ulcers: Persistent Pain and Treatment Concerns

On December 6th, I was diagnosed with a gastric ulcer in the emergency department. I have been experiencing pain in my lower back and thighs, and I have trouble sleeping at night. I underwent a CT scan and an endoscopy, but no abnormalities were found, only the confirmed gastric ...

Dr. Lin Minghui reply Gastroenterology and Hepatology
The pharmacological treatment for gastric ulcers may require 8 to 12 weeks, and it is important to understand the underlying causes of gastric ulcers. Chronic stress, irregular eating habits, Helicobacter pylori infection, alcohol consumption, smoking, and the use of analgesics c...

Weight Loss Due to Peptic Ulcers: Is PPI Use a Normal Factor?

Hello Dr. Ke, thank you for addressing my concerns regarding rectal bleeding. Additionally, is it normal to experience weight loss when taking proton pump inhibitors (PPIs) for peptic ulcers? About six months ago (September 2015), my weight was approximately 78 kg. After being di...

Dr. Ke Fangxu reply Surgery
The use of proton pump inhibitors (PPIs) for peptic ulcers does not cause weight loss; rather, it is more likely due to changes in dietary habits after being diagnosed with a peptic ulcer. If there have been no changes in diet or exercise habits, it is important to first check bl...

Managing Excess Stomach Acid: Is Vagotomy the Right Solution for You?

Due to excessive stomach acid and gastroesophageal reflux disease (GERD), I have been on medication for ten years. Currently, I am taking Losec and had switched to Tegament under my doctor's prescription for about three weeks. During this period, I experienced daily discomfo...

Dr. Chen Shidian reply Internal Medicine
It is recommended to visit a medical center for an examination of motility function and gastroesophageal reflux to assess the need for or apply for long-term treatment with Losec. Wishing you good health.

Understanding Appetite Loss and Anxiety in Gastric Ulcer Patients

Hello doctor, I have been experiencing persistent loss of appetite. Last Saturday, I underwent an endoscopy which diagnosed me with a gastric ulcer. The doctor prescribed me three medications: 1. Pantoprazole 2. Mosapride 3. Gaviscon. I have been taking them for 17 days. Initiall...

Dr. Ke Fangxu reply Surgery
Indeed, early-stage gastric cancer can present in the form of ulcers. If the physician has already performed an endoscopy and taken biopsies, there is no need for concern. Trust that your doctor and the pathology report indicate that a repeat endoscopy is unnecessary. Lack of app...