Abstract
BackgroundThis study aimed to understand the attitudes, beliefs, and concerns of physicians across India regarding the economic burden of diabetes and subsequently the cost-effectiveness of low-cost dapagliflozin for the management of patients with uncontrolled type 2 diabetes mellitus (T2DM) on background metformin therapy in Indian clinical settings.MethodA cross-sectional questionnaire survey was conducted among physicians treating people with T2DM with or without complications. The questions covered the general aspects of affordability and adherence to diabetes medications as well as specific details of low-cost dapagliflozin and its cost-effectiveness.ResultsIn total, 844 physicians provided a response to the survey questionnaire. The physicians who participated in the study included diabetologists, endocrinologists, cardiologists, consulting physicians, and family physicians. A majority of the physicians (53%) opined that only 10%-30% of their patients can afford the cost of newer antidiabetic medicines, while 25% of the physicians mentioned that <10% of their patients had issues related to affordability. Further, 39% of the physicians opined that 20%-40% of their patients discontinue the medicines due to high cost. Most of the physicians (95%) agreed that due to the low cost of dapagliflozin, it can be used for the primary prevention of heart failure in patients with T2DM in India. Similarly, 98% of the physicians agreed that it can be used for the treatment of heart failure in patients with or without T2DM in India. A majority of these physicians (93%) responded that switching from expensive sodium/glucose cotransporter-2 inhibitors (SGLT2i) to low-cost dapagliflozin is a long-term cost-effective management of T2DM. In total, 98% of the physicians agreed that low-cost dapagliflozin has the characteristics of an ideal SGLT2i because of its metabolic benefits, cardioprotection, nephroprotection, and potential cost-effectiveness.ConclusionThis survey-based study indicates that dapagliflozin is an effective and cost-saving therapy for patients with T2DM and complications. Low-cost dapagliflozin can revolutionize the treatment of T2DM in the Indian setting.
Highlights
Diabetes mellitus is a chronic metabolic disorder, one of the major causes of morbidity, mortality and needs lifelong treatment [1]
Most of the physicians (95%) agreed that due to the low cost of dapagliflozin, it can be used for the primary prevention of heart failure in patients with type 2 diabetes mellitus (T2DM) in India
98% of the physicians agreed that low-cost dapagliflozin has the characteristics of an ideal sodium/glucose cotransporter-2 inhibitors (SGLT2i) because of its metabolic benefits, cardioprotection, nephroprotection, and potential cost-effectiveness
Summary
Diabetes mellitus is a chronic metabolic disorder, one of the major causes of morbidity, mortality and needs lifelong treatment [1]. If not well managed, can lead to frequent hospital admissions and premature death [2] With this rising prevalence, it can be very well noted that diabetes is an epidemic that does not regard any financial status or any ethnic background. The burden of diabetes in India needs to focus on cost-effective measures such as early screening, tight metabolic control, monitoring of risk factors, and assessment of organ damage and economic management solutions [4]. This study aimed to understand the attitudes, beliefs, and concerns of physicians across India regarding the economic burden of diabetes and subsequently the cost-effectiveness of low-cost dapagliflozin for the management of patients with uncontrolled type 2 diabetes mellitus (T2DM) on background metformin therapy in Indian clinical settings
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