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2006年之前以及2010年、2014年新型药物推出之后德国初级医疗中2型糖尿病患者的变化。

Changes in Type 2 Diabetes Mellitus Patients in German Primary Care Prior to (2006) and After (2010, 2014) Launch of New Drugs.

作者信息

Jacob Louis, Waehlert Lilia, Kostev Karel

机构信息

Department of Biology, École Normale Supérieure de Lyon, Lyon, France.

Fresenius University of Applied Sciences, Health Economics, Idstein, Germany.

出版信息

J Diabetes Sci Technol. 2016 Feb 10;10(2):414-20. doi: 10.1177/1932296815607860.

Abstract

AIMS

The aim was to analyze the changes in a German type 2 diabetes population prior to (2006) and after (2010, 2014) launch of new drugs.

METHODS

Patients with T2DM in 2006, 2010, and 2014 were recruited for the study. Demographic data included age, gender, and health insurance type (private/statutory). Drug prescription, mean costs per patient, HbA1c levels, macrovascular complications, and time before first insulin prescription were analyzed.

RESULTS

In all, 64 098, 77 219, and 85 004 T2DM patients were included for 2006, 2010, and 2014, respectively. The mean age (65.9-66.9 years), proportion of men (50.8%-53.8%), and proportion of patients with private health insurance (6.6%-7.2%) differed significantly for each of the 3 years. There was a 1.25-fold increase in the total costs per patient, linked with an increase in the costs associated with the use of new drugs and a decrease in those associated with the use of old drugs, respectively. HbA1c levels were slightly better regulated in 2014 than in 2006 and 2010. The share of macrovascular complications decreased significantly over time, dropping from 27.4% in 2006 to 24.6% in 2014. The mean duration before first insulin treatment increased from 1225 days in 2006 to 1406 days in 2014.

CONCLUSIONS

The new drugs analyzed in this study had positive effects on HbA1c levels, macrovascular complications, and mean time before first insulin treatment.

摘要

目的

本研究旨在分析德国2型糖尿病患者群体在新药上市前(2006年)和上市后(2010年、2014年)的变化情况。

方法

招募2006年、2010年和2014年的2型糖尿病患者参与本研究。人口统计学数据包括年龄、性别和医疗保险类型(私人/法定)。分析药物处方、每位患者的平均费用、糖化血红蛋白(HbA1c)水平、大血管并发症以及首次使用胰岛素前的时间。

结果

2006年、2010年和2014年分别纳入64098例、77219例和85004例2型糖尿病患者。这三年中,平均年龄(65.9 - 66.9岁)、男性比例(5??8% - 53.8%)和拥有私人医疗保险的患者比例(6.6% - 7.2%)均存在显著差异。每位患者的总费用增长了1.25倍,分别与使用新药相关费用的增加以及使用旧药相关费用的减少有关。2014年的HbA1c水平调控情况略优于2006年和2010年。大血管并发症的比例随时间显著下降,从2006年的27.4%降至2014年的24.6%。首次胰岛素治疗前的平均时长从2006年的1225天增加到2014年的1406天。

结论

本研究中分析的新药对HbA1c水平、大血管并发症以及首次胰岛素治疗前的平均时间具有积极影响。

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