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

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

doi:10.1371/journal.pone.0178764

Abstract

Aimto investigate the drug-class-specific changes in the volume and cost of antidiabetic medications in Poland in 2012–2015.MethodsThis retrospective analysis was conducted based on the National Health Fund database covering an entire Polish population. The volume of antidiabetic medications is reported according to ATC/DDD methodology, costs—in current international dollars, based on purchasing power parity.ResultsDuring a 4-year observational period the number of patients, consumption of antidiabetic drugs and costs increased by 17%, 21% and 20%, respectively. Biguanides are the basic diabetes medication with a 39% market share. The insulin market is still dominated by human insulins, new antidiabetics (incretins, thiazolidinediones) are practically absent. Insulins had the largest share in diabetes medications expenditures (67% in 2015). The increase in antidiabetic medications costs over the analysed period of time was mainly caused by the increased use of insulin analogues.ConclusionsThe observed tendencies correspond to the evidence-based HTA recommendations. The reimbursement status, the ratio of cost to clinical outcomes and data on the long-term safety have a deciding impact on how a drug is used.

Highlights

Diabetes mellitus is a prevalent multisystem metabolic disease associated with high health care resource expenditures
We have witnessed the development of several new antidiabetic medications, e.g. the dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide 1 (GLP-1) agonists, as well as a restriction of thiazolidinediones use as a result of safety monitoring data [1]
This is retrospective observational study based on healthcare administrative data from the National Health Fund (NHF), covering an entire Polish population of about 38 million inhabitants

Summary

Introduction

Diabetes mellitus is a prevalent multisystem metabolic disease associated with high health care resource expenditures. Effectiveness of treatment is often influenced by selection of medicines, therapy changes as well as patient adherence with prescribed drug regimens. Drug utilization studies which are defined as the marketing, distribution, prescription and use of drugs in a society with special emphasis on the resulting medical, social and economic consequences [2], provide useful insights into the current prescribing practices in typical usual-care settings and play a significant role in helping the health-care system to understand, interpret and improve the prescribing administration and use of medications. Administrative databases seem to be useful in analysing trends in the prescription pattern and the adherence to the cost-effective care recommended by both international and local guidelines [3]. The aim of our study was to investigate the drug-class-specific changes in the volume and cost of antidiabetic medications in Poland during years 2012–2015 and to assess how the observed tendencies correspond to the evidence-based HTA recommendations

Objectives

Methods

Results

Conclusion