Background The increase in deaths due to diabetes records a trend in growth and the OSMED National Report of 2011 highlights a prescription shift towards the high-cost innovative drugs for the treatment of type II diabetes mellitus (DMII). This is subject to intensive monitoring by the health ministry.
In the management of diabetic patients, the guidelines suggest an early intensive therapeutic intervention and the pursuit of a personal glycaemic target for avoiding hypoglycaemic episodes, which are possibly responsible for the increased risk of developing cardiovascular episodes.
Purpose To analyse the population, consumption and type of innovative diabetic drugs used in the Piedmont region; this is to put a value on the type of treatment used for DMII, because the advantages of innovative therapy must be valued too.
Materials and Methods In the first step the incidence of DMII in Piedmont was valued by analysing data from the regional diabetic database during the period 2007–2012. Dipeptidyl peptidase 4 inhibitors (sitagliptin and vildagliptin alone or in association with metformin and saxagliptin), thiazolidinediones (pioglitazone alone or in association with metformin), glucagon-like peptide 1 (exenatide, liraglutide), insulin glargine and detemir were considered innovative drugs. Consumption and type of drugs were analysed in terms of the defined daily dose/1000 inhabitants/day (DDD) over a six-month period in 2012 using regional databases of prescriptions which enabled us to access population data. 2012 data were compared with 2011.
Results The first striking finding is the increase in the incidence of DMII, 1.70% in five years, which corresponds to 80,327 patients. Focusing on the population treated with innovative drugs revealed that 21% (61,679/294,590) of diabetic patients are 65 years old and far more males than females are affected (respectively 53.87% vs. 46.13%). The drug most used is insulin glargine with 43.84% of total consumption, another 25.08% use DPP4 inhibitors alone or in association, 20.05% use pioglitazone alone or in association, 9.02% use glucagon-like peptide 1 and 2.01% use insulin detemir. The comparison with the same period of 2011 highlights the increased consumption of innovative drugs in Piedmont, 23% (8.97 DDD in 2012 vs. 6.91 DDD in 2011) while Italian data record an increase of 5% (15.69 DDD vs. 14.87 in 2011).
Conclusions Increased consumption of these drugs suggests that medical prescriptions could maybe move on innovative therapeutic molecules. It is important that clinicians discuss and compare the data analysis shown above with medical management guidelines, with the aim of estimating the genuine advantages of innovative drugs in terms of compliance, reduction in adverse reactions and increased quality of life.
No conflict of interest.
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