Editorial: Intravenous Proton Pump Inhibitors for Bleeding Peptic Ulcer: What is the Most Cost-Effective Approach?

During their lifetime, about 10% of the population will develop a peptic ulcer. Despite major advancements in the approach to peptic ulcer bleeding over the last 10-20 years including newer endoscopic hemostatic techniques and the advent of proton pump inhibitors (PPIs), upper gastrointestinal bleeding due to peptic ulcers results in substantial morbidity, mortality, and cost. Both oral and intravenous PPIs have proven to be effective in preventing recurrent bleeding from peptic ulcers. However, the dosing and administration of PPIs have been a source of ongoing debate, specifically in relation to cost. In this issue of the Journal, Lu et al. perform cost analysis demonstrating that costs from bleeding peptic ulcers are influenced more by efficient triage and discharge of patients than the nuances of variations in administration of intravenous PPI's.