PDB14 - Patterns of Pharmacological Treatment in Type 2 Diabetes in France in 2013

Abstract

With the introduction and delisting of some glucose-lowering medications, pharmacological treatments in T2D have changed in the recent years and details of the current drug use patterns are not known. This descriptive study aims to describe characteristics of patients with type 2 diabetes and patterns of use of antihyperglycemic agents in France in 2013. A random sample of ≈ 600,000 patients registered in the French national health insurances reimbursement database was used. Patients with diabetes were identified through their use of glucose-lowering medication and coding of hospital stays and long-standing condition insurance coverage in the database. Drug utilization pattern of antihyperglycemic agents were estimated considering prescriptions in Q4 2013 and compared to data from Q4 2007. Overall 28,708 patients with T2D (estimated database prevalence 4.5%, 8.8% in people aged 40 and over) were identified in 2013. Mean age was 67.5 (SD 12.9), 54.1% were male. In Q4, 41.2% of T2D pharmacologically treated patients received a monotherapy, 25.6% a dual therapy, 13.7% a multi-therapy and 19.5% an insulin therapy with or without other hypoglycemic agents. Compared to 2007 data, a slight but significant increasing trend toward combination therapies and insulin was observed. The use of metformin increased over time especially in monotherapy (66% among monotherapy in 2013 versus 50% in 2007). All thiazolidinediones and some sulfonylureas treatments were replaced by DPP-4 inhibitors and to a much lesser extent with GLP-1 analogues. Antihyperglycemic prescription patterns in France have changed in recent years in parallel with the introduction of different classes of medications to the marketplace but probably also in an attempt to improve glycemic control of patients. Knowledge of real life pattern of drug utilization remains an important dimension to better understand therapeutic needs in T2D management.