By Melissa Fleur AfsharShareNewsweek is a Trust Project memberA widely available drug that costs as little as 50 cents per dose could offer major savings for hospitals while reducing life-threatening complications in critically ill patients, according to a new study published in JAMA Network Open.
Researchers led from McMaster University have found that pantoprazole—a proton pump inhibitor used to prevent stomach bleeding—provides not only clinical protection for mechanically ventilated ICU patients but also significant economic advantages.
Pantoprazole is used to prevent upper gastrointestinal bleeding in patients at high risk due to invasive mechanical ventilation. These patients often suffer stress-related stomach ulcers, which can lead to bleeding, extended hospital stays, and increased treatment costs. The latest research confirms that routinely administering pantoprazole to these patients can reduce hospital costs by thousands of dollars per case.
...The analysis was conducted alongside data from the REVISE (Re-evaluating the Inhibition of Stress Erosions) trial, a randomized clinical study that included 4,821 critically ill adults across 68 intensive care units in the U.S., Australia, Brazil, Canada, England, Kuwait, Pakistan and Saudi Arabia.
Participants in the trial had a mean age of 58 years, and 36 percent were female.
The cost-effectiveness study compared outcomes and resource utilization for two groups of patients: one group that received daily intravenous pantoprazole and one that did not. Researchers tracked the patients from ICU admission through hospital discharge, using a public health care payer’s perspective.
Patients who received pantoprazole had slightly shorter ICU and hospital stays. The average ICU stay was 12.4 days for pantoprazole patients, compared to 13.3 days for those not treated with the drug. Hospital stays averaged 14.8 days for pantoprazole patients and 16.5 days for others.
The study also found that the mean total cost per patient was $60,466 for those treated with pantoprazole, compared with $65,423 for those who were not—an average savings of $4,957 per patient. In 99 percent of simulation models run by the researchers, pantoprazole was both more effective and less expensive than not administering the drug.
The economic benefit was even more pronounced when U.S.-based costs were applied across the entire patient population in a sensitivity analysis. Under this model, the average per-patient cost was $130,179 for pantoprazole-treated patients compared to $140,770 for those who did not receive it, yielding savings of $10,591 per patient.
When researchers removed the top 10 percent of high-cost patients in terms of ICU days, ward days, and total expenditures, the pantoprazole treatment group still demonstrated cost savings of $1,151 to $3,388 per patient, depending on the variable examined.
The findings offer practical implications for hospitals and health systems facing resource constraints. By demonstrating that pantoprazole is not only medically effective but also financially advantageous, the study supports wider adoption of routine pantoprazole administration for mechanically ventilated ICU patients.
Until now, the economic value of pantoprazole in this context had not been clearly established, but this study helps fill that gap and gives clinicians, pharmacy departments, and policymakers robust evidence to consider.
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Reference
Xie, F., Yao, Y., Ma, Y., Humphries, B., Lau, V. I., Fowler, R., Rochwerg, B., Heels-Ansdell, D., Zytaruk, N., Barletta, J. F., Kanji, S., Arabi, Y. M., Johnson, D. W., Williamson, D., Marshall, J. C., Deane, A., Myburgh, J., Geagea, A., Poole, A., Archambault, P., Khwaja, K., Ostermann, M., Burry, L., Guyatt, G. H., & Cook, D. J., for the E-REVISE Collaborators and the Canadian Critical Care Trials Group. (2025). Cost-effectiveness of pantoprazole to prevent upper gastrointestinal bleeding in mechanically ventilated patients. JAMA Network Open, 8(12). https://doi.org/10.1001/jamanetworkopen.2025.52771
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