Alfred Hospital, Melbourne, Victoria, Australia.
Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Intern Med J. 2022 May;52(5):841-847. doi: 10.1111/imj.15137.
Since the turn of the century, the prevalence of diabetes mellitus in Australia has increased, primarily due to rising rates of Type 2 diabetes. Simultaneously, the landscape of diabetes medications has evolved significantly. The change in prescribing trends and public spending on diabetes medications within Australia during this period are not well defined.
To establish the frequency and cost of dispensed diabetes medications in the Australian public healthcare system between 2003 and 2019.
We performed a longitudinal nationwide observational study using data obtained from the Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule websites, which contain information on frequency and spending of diabetes medications dispensed in Australia.
The total number of PBS-subsidised prescriptions dispensed for diabetes increased from 5 218 690 in 2003 to 12 188 568 in 2019, and spending increased from $117 241 031 to $598 904 983. Of the non-insulin agents, metformin was consistently the most frequently dispensed agent, with a rapid growth in metformin combination tablets. Dispensation of sulphonylureas and thiazolidinediones have declined, with a simultaneous increase in dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists.
Our data show a large growth in the use of diabetes medications between 2003 and 2019. The rapid growth in dispensing of drugs with proven cardiovascular and renal benefits reflect the evolving approach of diabetes treatment, from a historical approach targeting glycaemic control alone, to a modern individualised approach targeting specific co-morbidities.
自本世纪初以来，澳大利亚的糖尿病患病率有所上升，主要是由于 2 型糖尿病发病率的上升。与此同时，糖尿病药物治疗领域也发生了重大变化。在此期间，澳大利亚的处方趋势变化和糖尿病药物的公共支出情况尚不清楚。
确定 2003 年至 2019 年期间澳大利亚公共医疗保健系统中开具的糖尿病药物的频率和费用。
我们使用从药品福利计划（PBS）和医疗保险福利计划网站获得的数据进行了一项全国性的纵向观察性研究，这些数据包含了在澳大利亚开具的糖尿病药物的频率和支出信息。
2003 年，PBS 补贴的糖尿病处方总数从 5218690 增加到 2019 年的 12188568，支出从 117241031 美元增加到 598904983 美元。在非胰岛素药物中，二甲双胍一直是最常开的药物，二甲双胍复方片剂的增长迅速。磺酰脲类药物和噻唑烷二酮类药物的使用量有所下降，而二肽基肽酶-4 抑制剂、钠-葡萄糖协同转运蛋白 2 抑制剂和胰高血糖素样肽-1 受体激动剂的使用量同时增加。
我们的数据显示，2003 年至 2019 年间，糖尿病药物的使用量大幅增长。具有明确心血管和肾脏益处的药物的配药快速增长，反映了糖尿病治疗方法的不断发展，从单纯针对血糖控制的历史方法，发展到针对特定合并症的现代个体化方法。
