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

Csatordai, M; Benkő, Ria; Matuz, Mária; Bor, Andrea; Lengyel, Csaba; Doró, Péter

doi:10.1111/dme.14117

Cited by 4 publications

(10 citation statements)

References 14 publications

(12 reference statements)

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“…The higher use of fixed-dose combination may be explained by the ease of use, especially in patients with a higher degree of polypharmacy resulting in increased adherence to the medication. 39 As opposed to other countries, 19 infarction and non-fatal stroke was reported for empagliflozin 40 and in meta-analyses including all SGLT2i. 41 This study has several limitations.…”

Section: Discussionsmentioning

confidence: 96%

“…increase in empagliflozin prescription was observed after market introduction as the one reported in other countries 19. Both drugs have shown positive effects in patients with heart failure, decreasing the risk of hospitalisation for heart failure 29,31.…”

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confidence: 79%

“…The rising trend was similar to the one reported for other countries in the European region, for which national glucose-lowering medication utilisation data were also available. 19 However, the increase and the percentage of Note: One prescription may contain more than 1 antidiabetic drug.…”

Section: Discussionsmentioning

confidence: 99%

“…However, the increase and the percentage of market share was lower compared with the market share of the new ADM reported in these countries. For example, in 2017 in Hungary, the novel glucose‐lowering therapies represented 16% of the market share, 19 while in Estonia represented 18% 20 . The numbers were even higher in Norway and Finland, reaching 24% 21 and 29%, 22 respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The higher use of fixed‐dose combination may be explained by the ease of use, especially in patients with a higher degree of polypharmacy resulting in increased adherence to the medication 39 . As opposed to other countries, 19 in Romania no incentives are available for use of combination therapy.…”

Section: Discussionmentioning

confidence: 99%

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Drug utilisation study of antidiabetic medication during 2012‐2019 in Romania

et al. 2021

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Diabetes is a condition in continuous rise worldwide as reported in the ninth edition of the International Diabetes Federation (IDF) Diabetes Atlas 2019. 1 On a European level, IDF estimates number of 59.3 million adults (8.9% of the population aged 20-79 years) to have diabetes in 2019. According to an epidemiological study enrolling a sample representative for the population and which was performed in 2014, Romania was among the European countries with the highest diabetes prevalence (12.4%) of the adult population. 2 Among patients with diabetes worldwide, around 90% have type 2 diabetes (T2D). 1 Both prevalence and incidence of T2D are increasing worldwide, particularly in developing countries. 1 As for patients with diabetes, pharmacological management is necessary in most cases, several new antidiabetics for the treatment of T2D being released on the market in the past 15 years. These are glucagon-like peptide 1 receptor agonists (GLP-1 RA, first agent approved was exenatide in 2005), dipeptidyl peptidase-4 inhibitors (DPP-4i, a first agent approved was sitagliptin in 2006) and sodium-glucose transport protein-2 inhibitor (SGLT2i, first agent approved was dapagliflozin in 2012). The approval of these new agents provide more treatment options for T2D patients and providers, but the post-authorisation research findings on their benefits and risks can also complicate decision making. [1][2][3] Management strategies of T2D in Romania follow mostly the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) guidelines. The generally accepted target of HbA1c is below 7% for the majority of patients with T2D

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Section: Discussionsmentioning

confidence: 96%

mentioning

confidence: 79%

Section: Discussionsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Drug utilisation study of antidiabetic medication during 2012‐2019 in Romania

et al. 2021

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Trends in antidiabetic drug use and expenditure in public hospitals in Northwest China, 2012-21: a case study of Gansu Province

Cao,

Feng,

Yang

et al. 2024

BMC Health Serv Res

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Background Since the twenty-first century, the prevalence of diabetes has risen globally year by year. In Gansu Province, an economically underdeveloped province in northwest China, the cost of drugs for diabetes patients accounted for one-third of their total drug costs. To fundamentally reduce national drug expenditures and the burden of medication on the population, the relevant departments of government have continued to reform and improve drug policies. This study aimed to analyse long-term trends in antidiabetic drug use and expenditure in Gansu Province from 2012 to 2021 and to explore the role of pharmaceutical policy. Methods Data were obtained from the provincial centralised bidding and purchasing (CBP) platform. Drug use was quantified using the anatomical therapeutic chemistry/defined daily dose (ATC/DDD) method and standardised by DDD per 1000 inhabitants per day (DID), and drug expenditure was expressed in terms of the total amount and defined daily cost (DDC). Linear regression was used to analyse the trends and magnitude of drug use and expenditure. Results The overall trend in the use and expenditure of antidiabetic drugs was on the rise, with the use increasing from 1.04 in 2012 to 16.02 DID in 2021 and the expenditure increasing from 48.36 in 2012 to 496.42 million yuan in 2021 (from 7.66 to 76.95 million USD). Some new and expensive drugs changed in the use pattern, and their use and expenditure shares (as the percentage of all antidiabetic drugs) increased from 0 to 11.17% and 11.37%, but insulins and analogues and biguanides remained the most used drug class. The DDC of oral drugs all showed a decreasing trend, but essential medicines (EMs) and medical insurance drugs DDC gradually decreased with increasing use. The price reduction of the bid-winning drugs was over 40%, and the top three drugs were glimepiride 2mg/30, acarbose 50mg/30 and acarbose 100mg/30. Conclusions The implementation of pharmaceutical policies has significantly increased drug use and expenditure while reducing drug prices, and the introduction of novel drugs and updated treatment guidelines has led to changes in use patterns.

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Trends and regional differences in antidiabetic medication use: a nationwide retrospective observational study

Csatordai,

Benkő,

Matuz

et al. 2024

Diabetol Metab Syndr

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Background The prevalence of diabetes is increasing, and several new drug groups have been authorized and used successfully in the treatment of diabetes, while older drug groups are still in use. Our aim was to assess the utilization tendencies and regional differences in antidiabetic medication consumption in Hungary between 2015 and 2021 and to identify the possible determinants of regional differences in antidiabetic medication use. Methods For this retrospective drug utilization study, yearly wholesale database was used, which provides total coverage for ambulatory antidiabetic drug sales in Hungary, including both reimbursed and non-reimbursed medications. Data were expressed as Defined Daily Dose per 1000 inhabitants per day (DDD/TID), percentage of total use and the ratio of the highest and lowest utilization values among the counties (max/min ratio). To assess the potential reasons for regional differences in antidiabetic drug use, we analyzed the associations between regional drug utilization data and possible determinants. Results The total national antidiabetic medication use has increased by 7.6% and reached 94.8 DDD/TID in 2021. Regarding antidiabetic subgroups, the use of metformin and novel antidiabetics (DPP4Is, GLP1As and SGLT2Is) and their combinations increased in all counties, while sulfonylurea consumption decreased, and insulin use was stable. In 2021, 19.2–24.1% of the total antidiabetic medication consumption was novel antidiabetics, 39.1–47.2% metformin, 14.8–25.8% sulfonylureas and 23.6–30.5% were insulins. Regional differences in antidiabetic medication consumption were considerable mainly in the case of GLP1As (max/min ratio:3.00), sulfonylureas (2.03) and SGLT2Is (1.92) in 2021. The association between antidiabetic medication use and possible determinants was confirmed in the case of unemployment rate and sulfonylurea use, the number of public medical card holders per ten thousand inhabitants and human insulin and sulfonylurea use. GLP1As were the only antidiabetic drug group that did not correlate with any of the investigated factors. Conclusions Although novel antidiabetic drug use was growing dynamically in Hungary, sulfonylurea use is still considerable. Differences in antidiabetic drug consumption were substantial between the regions.

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

Cited by 4 publications

References 14 publications

Drug utilisation study of antidiabetic medication during 2012‐2019 in Romania

Drug utilisation study of antidiabetic medication during 2012‐2019 in Romania

Trends in antidiabetic drug use and expenditure in public hospitals in Northwest China, 2012-21: a case study of Gansu Province

Trends and regional differences in antidiabetic medication use: a nationwide retrospective observational study

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