Drug-class-specific changes in the volume and cost of antidiabetic medications in Poland between 2012 and 2015

Śliwczyński, Andrzej; Brzozowska, Melania; Jacyna, Andrzej; Iltchev, Petre; Iwańczuk, Tymoteusz; Wierzba, Waldemar; Marczak, Michał; Orlewska, Katarzyna; Szymański, Piotr; Orlewska, Ewa

doi:10.1371/journal.pone.0178764

Cited by 10 publications

(11 citation statements)

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“…They also provide the opportunity to explore how the availability of new drug groups may reshape prescribing patterns in certain health conditions. Although studies on glucose‐lowering drug utilization changes have been conducted in Hungary and in several other countries, in recent years the use of novel glucose‐lowering drug groups specifically has not yet been analysed in detail in Hungary .…”

Section: Introductionmentioning

confidence: 99%

Use of glucose‐lowering drugs in Hungary between 2008 and 2017: the increasing use of novel glucose‐lowering drug groups

et al. 2019

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Aims To analyse glucose‐lowering drug utilization, focusing on the novel glucose‐lowering drug groups dipeptidyl peptidase‐4 inhibitors, glucagon‐like peptide‐1 receptor agonists and sodium‐glucose co‐transporter‐2 inhibitors, and the financial burden they entail. Methods Crude reimbursed national drug utilization and expenditure data for the entire population of Hungary were obtained from the National Health Insurance Fund for the study period: 2008 to 2017. Data were analysed using the WHO's Anatomical Therapeutic Chemical Classification/defined daily dose system and were expressed in defined daily dose per 1000 inhabitants per day. Results Total glucose‐lowering drug consumption in Hungary showed an 18% increase over the study period, reaching 74.7 defined daily doses per 1000 inhabitants per day, while novel glucose‐lowering drug use increased to 11.7 defined daily doses per 1000 inhabitants per day (16% of total glucose‐lowering drug use) by 2017. Dipeptidyl‐peptidase 4 inhibitor consumption grew to 7.4 defined daily doses per 1000 inhabitants per day by 2017. The most widely used dipeptidyl‐peptidase 4 inhibitor was sitagliptin. Glucagon‐like peptide‐1 receptor agonists were used the least, but by 2017 rose to 1.5 defined daily doses per 1000 inhabitants per day, led by liraglutide. Sodium‐glucose co‐transporter‐2 inhibitors appeared in the utilization data in 2014 and their consumption, mainly empagliflozin, reached 2.8 defined daily doses per 1000 inhabitants per day by 2017. The total expenditure on glucose‐lowering drugs increased 94% between 2008 and 2017, and the total cost of novel glucose‐lowering drug utilization comprised 44% of the total glucose‐lowering drug expenditure in 2017. Conclusions Both the use of and the financial burden posed by novel glucose‐lowering drugs in Hungary increased steadily between 2008 and 2017. This increase is expected to continue.

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Section: Introductionmentioning

confidence: 99%

Use of glucose‐lowering drugs in Hungary between 2008 and 2017: the increasing use of novel glucose‐lowering drug groups

et al. 2019

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“…19 In contrast, over a similar time period in Poland, insulins remained responsible for the majority of expenditure on diabetes-specific items. 26 This can be explained by reimbursement policies in Poland. For instance, newer drug classes such as DDP-4 inhibitors are not reimbursable due to insufficient evidence on the impact of their long-term use and the high cost per item.…”

Section: Discussionmentioning

confidence: 99%

Trends in national pharmaceutical expenditure on diabetes in Ireland 2011–2015: a repeated cross-sectional study

et al. 2020

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ObjectivesTo explore trends in pharmaceutical expenditure on diabetes between 2011 and 2015, describing trends in expenditure on blood glucose-lowering medications and estimating the effect of cost-containment measures implemented during this time.DesignRepeated cross-sectional study of national pharmacy claims data in Ireland.ParticipantsPatients’ dispensed items used in the treatment or management of diabetes.Primary and secondary outcomesTotal expenditure associated with diabetes was calculated by extracting data on all diabetes-related items dispensed to eligible patients. Costs were categorised into two groups. Diabetes-specific items include items used directly in diabetes treatment (WHO-Anatomical Therapeutic Chemical (ATC): A10, V07, V04) and diabetes-related include all other condition-related items (WHO-ATC: B01, C, H04, N03, N06). The impacts of two specific cost-containment measures, co-payments and reference pricing, were assessed using segmented linear regression analyses of interrupted time-series.ResultsTotal expenditure varied over the study period, peaking at €216 994 441 in 2012. Expenditure on diabetes-specific items increased steadily by 18% reaching €153 621 477 in 2015, with blood glucose-lowering medications accounting for 73% of this increase. During the same period, expenditure on diabetes-related items decreased by 32% to €50 835 856. The introduction of reference pricing for atorvastatin in November 2013 resulted in immediate costs savings of €2.4 million per yearly quarter (level-change p<0.001).ConclusionsThe increasing expenditure on blood glucose-lowering medications negates the effect of recent cost-containment measures, presenting a significant challenge for the provision of diabetes care. Innovative policies are required to ensure high-quality diabetes care can be provided at an equitable, affordable and sustainable rate.

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“…Among new antidiabetic drugs launched recently, DPP4i has been used in a certain proportion for the treatment of T2DM in the world . Compared with BG, the first‐line antidiabetic medication in many Western countries, few studies have investigated the efficacy or effectiveness of DPP4i for glycaemic control and prevention of diabetic comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Comparison of effectiveness and drug cost between dipeptidyl peptidase‐4 inhibitor and biguanide as the first‐line anti‐hyperglycaemic medication among Japanese working generation with type 2 diabetes

Ihana‐Sugiyama

Sugiyama

Tanaka

et al. 2019

Evaluation Clinical Practice

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Aims and Objectives:Dipeptidyl peptidase-4 inhibitor (DPP4i) is widely used for the treatment of type 2 diabetes (T2DM) in several countries such as Japan, whereas biguanide (BG; mostly metformin) is recommended as a first-line antidiabetic medication in many countries according to evidence mainly from Western countries.Although previous studies reported that DPP4i may be more efficacious for East Asians, direct comparisons of effectiveness and cost between DPP4i and BG have never been conducted in East Asia. Methods: We extracted claims and medical check-up data (observation period from January 2010 to March 2016) of adult patients under 70 years old with T2DM who received DPP4i or BG as first-line antidiabetic drugs. Changes in HbA1c and BMI before and 2 years after the first prescription and annual cost of antidiabetic medication during the second year were compared between the DPP4i and BG groups. Results: We extracted 1034 patients who received DPP4i and 365 patients who received BG as the first antidiabetic medication (male sex, 83.0% and 84.9%; HbA1c (mean [SD]), 7.7 [1.4]% and 7.9 [1.4]%; BMI, 26.6 [4.5] kg/m 2 and 28.1 [4.3] kg/m 2 ). After propensity score matching, changes in HbA1c and BMI were not significantly different between the groups (HbA1c, −0.67% vs −0.80% [P = .28]; BMI, −0.3 kg/m 2 vs −0.4 kg/m 2 [P = .42]). Annual cost of antidiabetic drugs was significantly higher in the DPP4i group (US $458.7 vs 273.3 [P < .001]). Many patients continued each medication at the follow-up visit (78.3% of the DPP4i group and 73.7% of the BG groups). ---This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.Abbreviations: BG, biguanide; DPP4i, dipeptidyl peptidase-4 inhibitor; SGLT2i, sodium glucose transporter 2 inhibitor; T2DM, type 2 diabetes; UKPDS, the UK Prospective Diabetes Study

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Drug-class-specific changes in the volume and cost of antidiabetic medications in Poland between 2012 and 2015

Cited by 10 publications

References 20 publications

Use of glucose‐lowering drugs in Hungary between 2008 and 2017: the increasing use of novel glucose‐lowering drug groups

Use of glucose‐lowering drugs in Hungary between 2008 and 2017: the increasing use of novel glucose‐lowering drug groups

Trends in national pharmaceutical expenditure on diabetes in Ireland 2011–2015: a repeated cross-sectional study

Comparison of effectiveness and drug cost between dipeptidyl peptidase‐4 inhibitor and biguanide as the first‐line anti‐hyperglycaemic medication among Japanese working generation with type 2 diabetes

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