Patterns of glucose lowering drugs utilization in Portugal and in the Netherlands. Trends over time

Torre, Carla; Guerreiro, José; Martins, Sofia Oliveira; Raposo, João Filipe; Martins, Ana Paula; Leufkens, Hubert G. M.

doi:10.1016/j.pcd.2015.03.009

Cited by 16 publications

(10 citation statements)

References 29 publications

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“…Moreover, the proportion of glucose-lowering drug users who were on insulin was considerably lower and more stable in the UK (20%–24% during 2000–2013) than in Denmark (41%–33% during 2004–2014). 10 Annual glucose-lowering drug consumption (measured in DDDs per 1,000 inhabitants per day) in Portugal and the Netherlands appeared to increase with only 32% and 13%, respectively, between 2004 and 2013, 11 compared with the ~65% increase in the prevalence of glucose-lowering drug users in Denmark during the same period. Different units of measurement may have contributed to these differences.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the decrease of SU use in the Netherland was less pronounced than that in Denmark (DDDs per 1,000 per day ≈30 in 2004, 23 in 2013). 11 American (2003–2012) 13 and Japanese (2005–2011) 14 data also showed an increasing use of metformin and the newer drug classes, whereas the use of sulfonylureas and thiazolidinediones declined. The observed decrease in thiazolidinedione sale from 2007 onward can probably be ascribed to cardiovascular and other safety alerts in the late 2000s.…”

Section: Discussionmentioning

confidence: 99%

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Nationwide trends in glucose-lowering drug use, Denmark, 1999–2014

Christensen¹,

Rungby²,

Thomsen³

2016

CLEP

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PurposeThe objective of this study was to examine nationwide population-based time trends in the utilization of all glucose-lowering drugs in Denmark from 1999 to 2014.MethodsBased on nationwide data from the Register of Medicinal Products Statistics, we retrieved sales statistics on glucose-lowering drugs and reported the total number of users and the prevalence of users per 1,000 inhabitants in 1-year intervals for all glucose-lowering drug classes.ResultsThe annual prevalence of glucose-lowering drug users increased more than twofold from 19 per 1,000 inhabitants in 1999 (n=98,362) to 41 per 1,000 in 2014 (n=233,230). Metformin use increased more than sevenfold during the period and was used by 30 of 1,000 inhabitants in 2014, while the prevalence of insulin use increased 1.8-fold to 13 per 1,000 in 2014. After peaking in 2007, use of sulfonylurea halved to 6 per 1,000 in 2014. Newer drug classes including the glucagon-like peptide 1 receptor agonists, the dipeptidylpeptidase-4 inhibitors, and the sodium–glucose cotransporter 2 inhibitors had reached a considerable position by 2014, with 4 per 1,000, 6 per 1,000, and 0.8 per 1,000 inhabitants, respectively; however, the use of glucagon-like peptide 1 receptor agonists and sodium–glucose cotransporter 2 inhibitors in elderly people remained low. Thiazolidinediones decreased to virtually no use (0.03 per 1,000) in 2014.ConclusionThe use of glucose-lowering drugs has doubled during 1999–2014. The pattern of glucose-lowering drug use has changed substantially reflecting the recommendations of metformin as first-line treatment. The newer glucose-lowering drug classes have been well received.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nationwide trends in glucose-lowering drug use, Denmark, 1999–2014

Christensen¹,

Rungby²,

Thomsen³

2016

CLEP

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“…However, the current state of clinical practice is not clear, with surprisingly little reliable information. Previous health economic studies mainly focused on the costs of diabetes [ 8 – 13 ] or national prescription trends [ 14 – 18 ]. The few studies that have investigated the costs, timing and duration of individual therapies [ 19 – 21 ] have mostly focused on first-line therapy.…”

Section: Introductionmentioning

confidence: 99%

Costs and Treatment Pathways for Type 2 Diabetes in the UK: A Mastermind Cohort Study

et al. 2017

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IntroductionMedication therapy for type 2 diabetes has become increasingly complex, and there are few reliable data on the current state of clinical practice. We report treatment pathways and associated costs of medication therapy for people with type 2 diabetes in the UK, their variability and changes over time.MethodsPrescription and biomarker data for 7159 people with type 2 diabetes were extracted from the GoDARTS cohort study, covering the period 1989–2013. Average follow-up was 10 years. Individuals were prescribed on average 2.4 (SD: 1.2) drugs with average annual costs of £241. We calculated summary statistics for first- and second-line therapies. Linear regression models were used to estimate associations between therapy characteristics and baseline patient characteristics.ResultsAverage time from diagnosis to first prescription was 3 years (SD: 4.0 years). Almost all first-line therapy (98%) was monotherapy, with average annual cost of £83 (SD: £204) for 3.8 (SD: 3.5) years. Second-line therapy was initiated in 73% of all individuals, at an average annual cost of £219 (SD: £305). Therapies involving insulin were markedly more expensive than other common therapies. Baseline HbA1c was unrelated to future therapy costs, but higher average HbA1c levels over time were associated with higher costs.ConclusionsMedication therapy has undergone substantial changes during the period covered in this study. For example, therapy is initiated earlier and is less expensive than in the past. The data provided in this study will prove useful for future modelling studies, e.g. of stratified treatment approaches.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-017-0296-x) contains supplementary material, which is available to authorized users.

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“…7 21 22 Similar patterns have been observed across Europe, with insulin use remaining relatively stable in recent years. [23][24][25] In the UK, expenditure on blood glucose-lowering drugs now also exceeds the costs of all insulins. 19 In contrast, over a similar time period in Poland, insulins remained responsible for the majority of expenditure on diabetes-specific items.…”

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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Patterns of glucose lowering drugs utilization in Portugal and in the Netherlands. Trends over time

Cited by 16 publications

References 29 publications

Nationwide trends in glucose-lowering drug use, Denmark, 1999–2014

Nationwide trends in glucose-lowering drug use, Denmark, 1999–2014

Costs and Treatment Pathways for Type 2 Diabetes in the UK: A Mastermind Cohort Study

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

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Patterns of glucose lowering drugs utilization in Portugal and in the Netherlands. Trends over time

Cited by 16 publications

References 29 publications

Nationwide trends in glucose-lowering drug use, Denmark, 1999&ndash;2014

Nationwide trends in glucose-lowering drug use, Denmark, 1999&ndash;2014

Costs and Treatment Pathways for Type 2 Diabetes in the UK: A Mastermind Cohort Study

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

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Nationwide trends in glucose-lowering drug use, Denmark, 1999–2014

Nationwide trends in glucose-lowering drug use, Denmark, 1999–2014