PDB11 DRUG-USE PATTERNS OF INITIALLY PRESCRIBED INSULIN DETEMIR AND INSULIN GLARGINE IN THE NETHERLANDS;A COMPARATIVE ANALYSIS USING PHARMACY DATA FROM IADB. NL

Abstract

OBJECTIVES: Newer long-acting insulin analogs have shown to result in several treatment improvements if compared with NPH insulins. Promising results from clinical trials require confirmation from observational settings reflecting potential “real-life” benefits. Therefore, the current study aimed to evaluate trends in prescribing (uptake), treatment adherence, and costs of (newer) insulin analogs (e.g., insulin detemir and insulin glargine). METHODS: A drug-utilization analysis was conducted based on using daily- practice prescription data from IADB.nl (one of the databases available in the Mondri- aan infrastructure), a dispensing database of 50 pharmacies, covering a Dutch population of 500,000. Drug-utilization data were collected for a 7-year period (2000-2007). All patients that received at least one prescription of an insulin analog-defined following the “Anatomical Therapeutical Classification” (ATC) as “A10A”-were included for this study. The prevalence and incidence of insulin use were both presented per 1000 population. Survival analysis was conducted to calculate the persistence on different insulin analogs. RESULTS: Preliminary results show a fast increase in the proportion of patients using the newer long-acting insulin analogs with 7% in 2003 to over 30% in 2006. Among patients initiating these newer insulin analogs, use of insulin glargine is more than two times higher compared to use of insulin detemir (507 vs. 190 starters in 2006). Patients that initiated treatment with long-acting insulin analogs were significantly more adherent to insulin glargine compared to insulin detemir (exact figures will be presented during the presentation). CONCLUSIONS: Current preliminary results show an increase in use of long-acting insulin analogs. Of these analogs, insulin glargine is most often initiated and seems to be well-received by patients. Further results will be presented based on a longer follow-up period including differences in HbAlc level dependent dosing and trends in cost development for insulin analogs over time. Also, the potential feature of “channelling” will be investigated.