Liatis S, Thomakos P, Papaoikonomou S, Papazafeiropoulou A, Giannakopoulos N, Karagiaouri E, Sotiropoulos A, Bousboulas S, Melidonis A, Pappas S, Katsilambros N
First Department of Internal Medicine, Athens University Medical School and Diabetes Center, Laiko Hospital, 17 Ag. Thoma, 11527 Athens, Greece.
Exp Clin Endocrinol Diabetes. 2009 Oct;117(9):505-10. doi: 10.1055/s-0029-1225338. Epub 2009 Jul 23.
AIMS Aim of the present study is to compare control of hyperglycaemia and other diabetes-related cardiovascular risk factors during the years 1998 and 2006 and to estimate the change in the cost of medications prescribed for this purpose. METHODS We compared the medical records of all patients who were regularly followed in three major diabetes centers located in Athens and Piraeus, Greece, during 1998, with those who were examined at the same centers during 2006. The cost of medications was calculated in Euros per patient-year (euroPY), using the 2006 official Greek market prices. RESULTS A total of 1 743 eligible files were included in the study (805 files from 1998 and 938 from 2006). HbA (1c), LDL-cholesterol and blood pressure improved significantly in 2006 as compared to 1998 (7.0% vs. 8.1%, 2.9 mmol/l vs. 3.9 mmol/l and 134.9/77.6 mmHg vs. 139.3/80.9 mmHg respectively, p<0.001 for all comparisons). Treatment of hyperglycaemia was more intense and had a different pattern in 2006. The proportion of patients receiving antihypertensive, hypolipidaemic and antiplatelet drugs increased from 48.8% to 74.4%, from 15.2% to 61.2% and from 17.6% to 51.1% respectively (p<0.001 for all comparisons). A highly significant increase in the cost per patient-year was observed for all classes of medications in 2006. The total cost of all diabetes-related medications increased in 2006 by 221.1% (from 341.3+/-276.0 euroPY to 1095.8+/-634.1 euroPY). CONCLUSIONS Control of cardiovascular risk factors of patients with T2D, regularly followed by diabetes specialists, improved significantly in 2006 as compared to 1998. This improvement, however, was associated with a considerable increase in the cost of medications prescribed for treatment of these parameters.
目的 本研究的目的是比较1998年和2006年期间高血糖及其他糖尿病相关心血管危险因素的控制情况，并估算为此所开药物治疗费用的变化。方法 我们将1998年在希腊雅典和比雷埃夫斯的三个主要糖尿病中心定期随访的所有患者的病历，与2006年在同一中心接受检查的患者病历进行比较。使用2006年希腊官方市场价格，以欧元/患者年（euroPY）计算药物费用。结果 本研究共纳入1743份符合条件的档案（1998年805份，2006年938份）。与1998年相比，2006年糖化血红蛋白（HbA1c）、低密度脂蛋白胆固醇和血压有显著改善（分别为7.0%对8.1%、2.9 mmol/l对3.9 mmol/l以及134.9/77.6 mmHg对139.3/80.9 mmHg，所有比较p<0.001）。2006年高血糖治疗更强化且模式不同。接受抗高血压、降血脂和抗血小板药物治疗的患者比例分别从48.8%增至74.4%、从15.2%增至61.2%以及从17.6%增至51.1%（所有比较p<0.001）。2006年各类药物的患者年费用均有高度显著增加。2006年所有糖尿病相关药物的总费用增加了221.1%（从341.3±276.0 euroPY增至1095.8±634.1 euroPY）。结论 与1998年相比，2006年由糖尿病专科医生定期随访的2型糖尿病患者的心血管危险因素控制有显著改善。然而，这种改善与治疗这些指标所开药物费用的大幅增加相关。
