OBJECTIVE: In Ireland hospital prescribing is thought to influence general practitioner (GP) prescribing and GPs have expressed concern over recommendations originating from secondary care, particularly in relation to the impact on drug expenditure. The aim of this study was to examine the range of proton pump inhibitors (PPIs) prescribed to patients at hospital discharge (generic vs proprietary) and on follow-up in the community. METHODS: A national primary care prescription database (covering approximately 1.15 million persons) was used to identify patients (n=10,792) who received a hospital discharge prescription for a PPI (ATC code: A02BC) from July-December 2004 and were followed up for 3 months post discharge. RESULTS: Approximately 37.3% of patients discharged from hospital were prescribed lansoprazole (total ingredient cost = €48,691); 21.6% were prescribed esomeprazole (ingredient cost = €28,862); 21.4% were prescribed omeprazole (17.9% branded, ingredient cost = €37,764 and 3.5% generic, ingredient cost = €4,748); 16.6% were prescribed pantoprazole (ingredient cost = €18,612) and 3.1% were prescribed rabeprazole (ingredient cost = €3,243). Potential savings if the cheapest generic omeprazole equivalent were dispensed (instead of proprietary omeprazole) would be approximately 6.2% of the total hospital expenditure on PPIs for the period examined. When follow-up prescriptions in the community were examined approximately 60% of patients did not receive further PPI medication. Of those who continued to receive a prescription for a PPI, approximately 30% remained on the PPI prescribed in hospital. CONCLUSIONS: Considering that generic omeprazole has the same therapeutic indications as proprietary omeprazole, there exists a case for more generic PPI utilisation in Irish hospitals. However, the fact that lansoprazole is priced comparably to generic omeprazole is encouraging. Regarding follow-up PPI prescribing in the community, it appears that where follow-up prescriptions are issued, GPs are more likely to reproduce the hospital prescription, rather than switch to an alternative PPI.