Proton pump inhibitors (PPIs) are widely used for the management of acid-related gastrointestinal disorders. Although their clinical efficacy is generally comparable, differences in acid-suppressive potency, duration of action, and acquisition costs may influence prescribing patterns and healthcare expenditures. This study aims to evaluate PPI utilization patterns and costs among hospitalized patients at a tertiary hospital in Surabaya, Indonesia, during 2023–2024 and to identify potential cost-control measures. This retrospective descriptive study analyzed PPI utilization data from the hospital information system for 2023–2024 and pharmacy billing records of National Health Insurance (JKN) patients from October to December 2024. Four oral and five injectable PPI formulations were utilized during the study period. Generic omeprazole, in both oral and injectable forms, accounted for the largest proportion of PPI use. Although injectable lansoprazole was prescribed less frequently, it contributed substantially to overall PPI expenditures. Omeprazole, lansoprazole, and pantoprazole were the most commonly prescribed PPIs among JKN patients. Pantoprazole, despite not being included in the hospital formulary, continued to be used and showed an increasing utilization trend. A shift in prescribing patterns from omeprazole to lansoprazole and pantoprazole in December 2024 was associated with increased costs. Omeprazole represented the highest utilization volume, whereas lansoprazole accounted for the largest share of PPI-related expenditures. Cost-control strategies should focus on optimizing formulary compliance and ensuring the appropriate use of higher-cost PPIs. Further studies evaluating clinical outcomes and the impact of formulary restrictions on lansoprazole use are warranted.
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