Lower incidence of macrovascular complications in patients on insulin glargine versus those on basal human insulins: A population-based cohort study in Italy

Cammarota, Simona; Bruzzese, Dario; Catapano, Alberico L.; Citarella, Anna; Luca, Luigi De; Manzoli, Lamberto; Menditto, Enrica; Mezzetti, Andrea; Riegler, S; Putignano, Daria; Tragni, Elena; Novellino, Ettore; Riccardi, Gabriele

doi:10.1016/j.numecd.2013.04.002

Cited by 26 publications

(40 citation statements)

References 32 publications

(20 reference statements)

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“…The above databases had been previously validated and used to produce drug-utilization information. [20][21][22][23][24][25] Data sources were matched by record linkage analysis through a unique and anonymous personal identification code. Such code was created by a database manager uninvolved in the data analysis, preventing patient identification.…”

Section: Data Sourcementioning

confidence: 99%

<p>Drug Utilization Pattern of Antibiotics: The Role of Age, Sex and Municipalities in Determining Variation</p>

Orlando

Monetti

Juste

et al. 2020

RMHP

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Purpose: The purpose was to analyze drug prescription and antibiotic use by age and sex in Italy's Campania Region, and to estimate the distribution of prescription rates in children (≤14 years old), adults (between 15 and 65 years old), and older adults (≥65 years old) at a municipality level. Methods: This was a retrospective analysis of pharmacy records in Campania (Southern Italy), in 2016. Difference in antibiotic prescriptions in different age groups was assessed by prevalence rates. Age-adjusted prevalence rates were categorized into quintiles and mapped by the patient's municipality of residence. Relationship between prevalence rates for the different age groups was estimated using the non-parametric Spearman rank correlation test. Results: There were 2,738,118 were patients with at least one antibiotic prescription. Antibiotics prescription was higher in children aged <5 years and in the older adults aged >70 years. Prevalence rate distribution was different among municipalities in all age groups. A positive correlation between the rank distribution of prevalence rates at municipality level was identified for children and adults (rs=0.56; P<0.01), adults and the older adults (rs=0.79; P<0.01), and children and the older adults (rs=0.46; P<0.01). Among the studied age groups, the most prescribed antibiotic class was penicillin (except the older adults aged ≥85 years) ranging from 45% in children to 27.2% in the older adults. Fluoroquinolones were the least prescribed antibiotic class, ranging from 0.2% in children to 30.2% in the older adults. Conclusion: A considerably high use of antibiotic drugs has been detected in Campania Region, with values exceeding the regional and national average. Prescriptions at municipal level differ from one age group to another. Antibiotic use is often unjustified, and to decrease the number of prescriptions and improve their appropriateness, several measures at territorial level are recommended.

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Section: Data Sourcementioning

confidence: 99%

<p>Drug Utilization Pattern of Antibiotics: The Role of Age, Sex and Municipalities in Determining Variation</p>

Orlando

Monetti

Juste

et al. 2020

RMHP

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“…Recently, Cammarota et al . conducted a 3‐year longitudinal, retrospective cohort study in Italy and found that, compared with patients on intermediate/long‐acting human insulin, glargine users had significantly lower risks of a composite of diabetes‐related complications (including macrovascular, microvascular and metabolic complications) (HR 0.57; 95% CI 0.44, 0.74) and a composite of macrovascular complications (HR 0.61; 95% CI 0.44, 0.84), and a lower, but nonsignificant, risk of microvascular complications (HR 0.58; 95% CI 0.33, 1.04).…”

Section: Discussionmentioning

confidence: 99%

“…16–32 weeks), which makes it difficult to capture any long‐term diabetes‐related complications. Although two observational cohort studies were conducted, in the United States and Italy , respectively, to evaluate the effects of basal insulin on the risks of diabetes‐related complications, neither specifically targeted patients with type 1 diabetes. The present study thus aimed to evaluate the comparative risks of acute and chronic diabetes‐related complications of basal insulins (i.e.…”

Section: Introductionmentioning

confidence: 99%

Comparative risks of diabetes‐related complications of basal insulins: a longitudinal population‐based cohort of type 1 diabetes 1999–2013 in Taiwan

Lee

et al. 2017

Brit J Clinical Pharma

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“…However, there is plenty of evidence on this issue in the international literature [50]. For example, evidence has shown that compared with NPH, insulin analogues decreases the risk of severe hypoglycemia episodes by 38% (OR 0.62, 95% CI 0.42–0.91) [4], the risk of nocturnal hypoglycemia episodes by 46% (p = 0.04) [51], the risk of hospitalization due to the first severe hypoglycemic event by 21.7% (95% CI 9.6–32.1%,p<0.001) [52], the risk of hypoglycemic coma recurrence by 36.3% (95% CI 8.9–55.5%, p = 0.014) [52], hospitalizations by 49% [53], the incidence of macrovascular complications by 48% [54], and annual costs [55]. …”

Section: Discussionmentioning

confidence: 99%

Budget Impact of Long-Acting Insulin Analogues: The Case in Brazil

2016

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BackgroundLong-acting insulin analogues for type 1 diabetes (T1D) treatment have been available on the Brazilian market since 2002. However, the population cannot access the analogues through the public health system.ObjectiveTo estimate the incremental budget impact of long-acting insulin analogues coverage for T1D patients in the Brazilian public health system compared to NPH insulin.MethodsWe performed a budget impact analysis of a five-year period. The eligible population was projected using epidemiological data from the International Diabetes Federation estimates for patients between 0–14 and 20–79 years old. The prevalence of T1D was estimated in children, and the same proportion was applied to the 15-19-year-old group due to a gap in epidemiological information. We considered 4,944 new cases per year and a 34.61/100,000 inhabitants mortality rate. Market share for long-acting insulin analogues was assumed as 20% in the first year, reaching 40% in the fifth year. The mean daily dose was taken from clinical trials. We calculated the bargaining power of the Ministry of Health by dividing the price paid for human insulin in the last purchase by the average regulated price. We performed univariate and multivariate sensitivity analyses.ResultsThe incremental budget impact of long-acting insulin analogues was US$ 28.6 million in the first year, and reached US$ 58.7 million in the fifth year. The total incremental budget impact was US$ 217.9 million over the five-year period. The sensitivity analysis showed that the percentage of T1D among diabetic adults and the insulin analogue price were the main factors that affected the budget impact.ConclusionsThe cost of the first year of long-acting insulin analogue coverage would correspond to 0.03% of total public health expenditure. The main advantage of this study is that it identifies potential bargaining power because it features more realistic profiles of resource usage, once centralized purchasing is established as an economically sustainable strategy. Clinical guidelines restricting the use of insulin analogues would make the decision towards insulin analogue coverage more affordable.

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Lower incidence of macrovascular complications in patients on insulin glargine versus those on basal human insulins: A population-based cohort study in Italy

Cited by 26 publications

References 32 publications

<p>Drug Utilization Pattern of Antibiotics: The Role of Age, Sex and Municipalities in Determining Variation</p>

<p>Drug Utilization Pattern of Antibiotics: The Role of Age, Sex and Municipalities in Determining Variation</p>

Comparative risks of diabetes‐related complications of basal insulins: a longitudinal population‐based cohort of type 1 diabetes 1999–2013 in Taiwan

Budget Impact of Long-Acting Insulin Analogues: The Case in Brazil

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