OBJECTIVES: The uses of GI medications for the treatment of and/or prophylaxis of NSAID induced gastropathy can be costly and may not necessarily reduce the risk of more serious events. The aim of this study was to examine factors influencing the length of gastrointestinal (GI) medication usage period associated with concurrent NSAID use. METHODS: This retrospective drug utilization study examined 15-month pharmacy claims records extracted from a Pharmacy Benefit Manager’s database. Only patients (N=454) prescribed an NSAID with no prior GI medication use were included. This allowed the examination of those patients’ GI treatment pattern exclusively attributable to NSAID use. GI medication treatment period was evaluated by the Kaplan-Meier method. Factors affecting the length of treatment period were analyzed using Cox proportional hazard regression procedure. RESULTS: Approximately 30% of the patients received GI treatment longer than 180 days. The probabilities of a patient using GI medications longer than 30-, 180-, and 360-day were 73.40, 38.77 and 22.30% respectively. The mean and median GI medication usage time is 182 and 117 days (CI=90, 147). Cox’s proportional hazards regression indicated that advanced age (RR=0.983, CI=0.974, 0.993), long term NSAID therapy (RR=0.463, CI=0.348, 0.618), earlier introduction of GI treatment (RR=1.002 CI=1.000,1.003) , and proton pump inhibitors (PPI) (RR=0.656; CI=0469, 0.918) were associated with longer GI treatment periods. CONCLUSIONS: The results suggest that there is a tendency for patients to receive prolonged course of GI therapy once such treatment was initiated, even they were prescribed more potent PPIs. Further outcomes studies should be pursued to optimize the GI medication use associated with NSAID induced GI complications.