PDB94 - Evolution of the Market for oral Antidiabetic agents In Canada after Introduction of Dipeptidyl Peptidase-4 Inhibitors

Abstract

Type 2 diabetes mellitus (DM) accounts for over 90% of all diagnosed diabetes cases. Hyperglycemia is an important risk factor for diabetic complications, supporting the use of glucose-lowering agents in the treatment of diabetes. Among glucose-lowering agents to treat type 2 DM are oral antidiabetic (OAD) agents. The objective of this study was to evaluate the Canadian market for OAD agents since 2008, soon after dipeptidyl peptidase (DPP)-4 inhibitors were introduced. Data on retail prescriptions and on drugstore and hospital purchases of OAD agents in Canada were obtained from IMS Brogan. Number of prescriptions and purchases (in $Can) were collected for 2008, 2012 and 2014. Total number of prescriptions for OAD agents in Canada amounted to 13.6 million, 20.5 million and 23 million in 2008, 2012, and 2014, respectively. Contribution of the two OAD agents mainly prescribed, metformin and sulfonylureas, decreased during this period while percentage of prescriptions for DPP-4 inhibitors over total OAD agents increased from 0.075% to 6.5% and to 14.5%, respectively, driven by the increase in prescriptions of sitagliptin, sitagliptin/metformin, saxagliptin, and linagliptin. Total drugstore and hospital purchases for OAD agents in Canada reached $394.2 million, $418.7 million and $520.9 million in 2008, 2012, and 2014, respectively. Percentage of purchases of DPP-4 inhibitors over total OAD agents markedly increased during this period, from 0.5% to 34.1% and to 64.1%, respectively. OAD agents represent a market of more than half a billion dollars in Canada; this will likely continue to grow due to the increasing occurrence of cases of type 2 DM in the general population. Since their introduction in 2008, DPP-4 inhibitor use has grown rapidly so that in 2014, they captured approximately one-sixth of prescriptions and, at almost two-thirds of purchases, were the market leaders among OAD agents.