An article published in the New York Times on May 1, 2015 listed the 10 drugs on which Medicare Part D spent the most in 2013. The most costly ($2.53 billion) was the proton pump inhibitor (PPI) Nexium (esomeprazole magnesium), which has recently become available generically.

EFFICACY AND TOLERABILITY – PPIs are effective in relieving symptoms of gastroesophageal reflux disease (GERD) and in healing erosive esophagitis and peptic ulcers, and they are generally well tolerated. There is no convincing evidence that any one PPI is more effective or better tolerated than any other.1,2

DRUG INTERACTIONS – Omeprazole and esomeprazole are inhibitors of CYP2C19 and can increase serum concentrations of drugs metabolized by this pathway, such as diazepam (Valium, and generics) and phenytoin (Dilantin, and others). They can ... more      

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