Department of Public Health Policy, School of Public Health, University of West Attica, Greece.
First Department of Propaedeutic Medicine, Diabetes Center, Laiko Hospital, Medical School, National & Kapodistrian University of Athens, Greece.
Diabetes Res Clin Pract. 2020 Apr;162:108095. doi: 10.1016/j.diabres.2020.108095. Epub 2020 Feb 26.
To estimate and compare the prescription costs for the management of patients with diabetes over a period of 20 years in Greece, based on real world data.
The records of outpatients with T2D, monitored at three diabetes centres, were examined in four cross-sections (1998, 2006, 2012, 2018). Prescribed medicines per patient, along with a set of clinical indicators were recorded. Annual costs of pharmaceutical treatment per patient were calculated by using each year's nominal retail prices, as well as by adjusting for 2018 price levels, in order to account for price differences over time.
4066 patients were included in the analysis. Prescription patterns indicate a quick uptake of the new classes of glucose-lowering drugs and a reduction in the proportional use of sulfonylurea and glitazone. Adjusting for 2018 prices, the average total annual prescription cost per patient was 381.54 Euros (s.d. 297.44) in 1998 and 1147.21 Euros (s.d. 814.39) in 2018. Glucose-lowering drug costs per patient increase from 1998 onwards, whereas the costs of antihypertensive, antiplatelet and lipid-lowering treatment declined gradually, especially after 2006.
Per patient prescription costs for glucose-lowering drugs present a steep increase, in Greece over the last 20 years. Real-world evidence studies that compare this increase with the changes in patient outcomes are essential in order to examine whether a costs-vs-outcomes balance is optimal.
基于真实世界数据，估计并比较希腊 20 年来治疗糖尿病患者的处方费用。
对三家糖尿病中心监测的 2 型糖尿病门诊患者的记录进行了四次横断面研究（1998 年、2006 年、2012 年和 2018 年）。记录每位患者的处方药物以及一组临床指标。通过使用每年的名义零售价格计算每位患者每年的药物治疗费用，并根据 2018 年的价格水平进行调整，以考虑到随时间推移的价格差异。
共纳入 4066 名患者。处方模式表明，新型降糖药物迅速普及，磺酰脲类和格列酮类药物的使用比例降低。按 2018 年价格调整后，1998 年每位患者的平均年总处方费用为 381.54 欧元（标准差 297.44），2018 年为 1147.21 欧元（标准差 814.39）。自 1998 年以来，每位患者的降糖药物费用增加，而降压、抗血小板和降脂治疗的费用逐渐下降，尤其是 2006 年以后。
过去 20 年来，希腊每位患者的降糖药物处方费用呈大幅上升趋势。为了检验成本-效益是否最佳，有必要进行真实世界证据研究，比较这种增长与患者结局的变化。
