The pattern of prescribing of glucose modulating agents for type 2 diabetes in general practices in England 2016/17
The pattern of prescribing of glucose modulating agents for type 2 diabetes in general practices in England 2016/17
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DOI：
10.1111/ijcp.13080
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发表时间：
2018-04-01
影响因子：
2.6
通讯作者：
Stedman, Mike
中科院分区：
文献类型：
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作者：
Heald, Adrian H.;Livingston, Mark;Stedman, Mike
背景：2016/17 财年，糖尿病处方药数量为 5200 万种，总净成分成本为 9.837 亿英镑，高于 2006/07 财年的 2890 万种处方药和 5.724 亿英镑。抗糖尿病药物（英国国家处方集第 6.1.2 节）占糖尿病药物净成分总成本 9.837 亿英镑的 45.1%，占所有糖尿病处方药处方项目的 72.0%。 方法：我们研究了 2016/2017 年英国全科医生诊所使用许可治疗 2 型糖尿病的药物的使用方式。分析是在全科医生实践水平上进行的，而不是在患者数据水平上进行的。结果：单一疗法的年度处方成本/患者/药物类型差异很大，从格列齐特和格列美脲的 11 磅/年到利拉鲁肽的 885 磅/年。 SGLT-2i 药物的使用量以每年 70% 的速度强劲增长，达到约 100,000 DDD，95% 的全科医生诊所都有处方。对于相对少数的患者（占每日规定剂量的 1.3%）来说，利拉鲁肽的支出（占总剂量的 11%）较高，而艾塞那肽的支出仍然很大。利拉鲁肽的使用显着超过其他胰高血糖素样肽 1 (GLP-1) 激动剂。结论：我们的工作表明，调节 2 型糖尿病组织葡萄糖水平的药物成本很高，并且一些非仿制药制剂在处方数量和总体支出方面占据主导地位。有一些较旧的磺酰脲类药物正在使用，通常不应开处方。在一般实践水平上定期审核患者治疗将确保适当有针对性地使用许可药物及其成本效益。
Background: In the financial year 2016/17 there were 52.0 million items prescribed for diabetes at a total net ingredient cost of 983.7 pound million - up from 28.9 million prescription items and 572.4 pound million in 2006/07. Anti-diabetes drugs (British National Formulary section 6.1.2) make up 45.1 per cent of the total 983.7 pound million net ingredient cost of drugs used in diabetes and account for 72.0 per cent of prescription items for all diabetes prescribing.Methods: We examined the way that agents licensed to treat type 2 diabetes were used across GP practices in England in the year 2016/2017. Analysis was at a GP practice level not at the level of patient data.Results: Annual prescribing costs / patient / medication type for monotherapy varied considerable from 11 pound/year for gliclazide and glimepiride to 885 pound/year for Liraglutide. The use of SGLT-2i agents grew strongly at 70% per annum to around 100,000 DDD with prescriptions seen in 95% of GP practices. Liraglutide expenditure (11% of total) was high for a relatively small number of patients (1.3% of Defined Daily Doses), with still significant spend on exenatide. Liraglutide use significantly exceeded that of other glucagon-like peptide-1 (GLP-1) agonists.Conclusions: Our work demonstrates the significant cost of medication to modulate tissue glucose levels in type 2 diabetes and the dominance of some non-generic preparations in terms of number of prescriptions and overall spend. There are some older sulphonylureas in use, which should not generally be prescribed. Regular audit of patient treatment at a general practice level will ensure appropriate targeted use of licensed medications and of their cost effectiveness.