Original Investigation

Cost-Effectiveness of Pantoprazole to Prevent Upper Gastrointestinal Bleeding in Mechanically Ventilated Patients

JAMA Network Open 10.1001/jamanetworkopen.2025.52771

December 01, 2025 at 11:00 AM EST

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Is daily intravenous pantoprazole cost-effective in preventing upper gastrointestinal bleeding in mechanically ventilated patients compared with no pantoprazole?This economic evaluation including 4821 patients from the Reevaluating the Inhibition of Stress Erosions trial found that prophylactic pantoprazole was associated with a significantly lower rate of clinically important upper gastrointestinal bleeding and a lower mean total cost per patient compared with no pantoprazole.This economic evaluation found that prescribing daily pantoprazole for invasively mechanically ventilated patients was less costly and more effective than care without pantoprazole, indicating both clinical benefits and economic value for the health care system.

Corresponding Author: Feng Xie, PhD, Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON, Canada (fengxie@mcmaster.ca).

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