Sharma Kamal, Chandorkar A B, Kovil Rajiv, Venkataraman S, Subrahmanyam Kav, Mandal Parthasarathi, Wasir Jasjeet, Abhyankar Mahesh, Prasad Ashish, Sarda Prashant S
Department of Cardiology, Dr. Kamal Sharma Cardiology Clinic, Ahmedabad, IND.
Department of Cardiology, Ruby Hall Clinic, Pune, IND.
Cureus. 2021 Nov 1;13(11):e19194. doi: 10.7759/cureus.19194. eCollection 2021 Nov.
Background This study aimed to understand the attitudes, beliefs, and concerns of physicians across India regarding the economic burden of diabetes and subsequently the cost-effectiveness of low-cost dapagliflozin for the management of patients with uncontrolled type 2 diabetes mellitus (T2DM) on background metformin therapy in Indian clinical settings. Method A cross-sectional questionnaire survey was conducted among physicians treating people with T2DM with or without complications. The questions covered the general aspects of affordability and adherence to diabetes medications as well as specific details of low-cost dapagliflozin and its cost-effectiveness. Results In total, 844 physicians provided a response to the survey questionnaire. The physicians who participated in the study included diabetologists, endocrinologists, cardiologists, consulting physicians, and family physicians. A majority of the physicians (53%) opined that only 10%-30% of their patients can afford the cost of newer antidiabetic medicines, while 25% of the physicians mentioned that <10% of their patients had issues related to affordability. Further, 39% of the physicians opined that 20%-40% of their patients discontinue the medicines due to high cost. Most of the physicians (95%) agreed that due to the low cost of dapagliflozin, it can be used for the primary prevention of heart failure in patients with T2DM in India. Similarly, 98% of the physicians agreed that it can be used for the treatment of heart failure in patients with or without T2DM in India. A majority of these physicians (93%) responded that switching from expensive sodium/glucose cotransporter-2 inhibitors (SGLT2i) to low-cost dapagliflozin is a long-term cost-effective management of T2DM. In total, 98% of the physicians agreed that low-cost dapagliflozin has the characteristics of an ideal SGLT2i because of its metabolic benefits, cardioprotection, nephroprotection, and potential cost-effectiveness. Conclusion This survey-based study indicates that dapagliflozin is an effective and cost-saving therapy for patients with T2DM and complications. Low-cost dapagliflozin can revolutionize the treatment of T2DM in the Indian setting.
背景 本研究旨在了解印度各地医生对糖尿病经济负担的态度、信念和担忧，以及在印度临床环境中，低成本的达格列净用于治疗接受二甲双胍基础治疗但血糖控制不佳的2型糖尿病（T2DM）患者的成本效益。方法 对治疗有或无并发症的T2DM患者的医生进行了横断面问卷调查。问题涵盖了糖尿病药物可负担性和依从性的一般方面，以及低成本达格列净及其成本效益的具体细节。结果 共有844名医生回复了调查问卷。参与研究的医生包括糖尿病专家、内分泌学家、心脏病专家、会诊医生和家庭医生。大多数医生（53%）认为只有10%-30%的患者能够负担新型抗糖尿病药物的费用，而25%的医生提到他们的患者中不到10%有可负担性相关问题。此外，39%的医生认为20%-40%的患者因费用高而停药。大多数医生（95%）同意，由于达格列净成本低，它可用于印度T2DM患者心力衰竭的一级预防。同样，98%的医生同意它可用于印度有或无T2DM患者心力衰竭的治疗。这些医生中的大多数（93%）回答说，从昂贵的钠/葡萄糖协同转运蛋白2抑制剂（SGLT2i）改用低成本的达格列净是T2DM的一种长期具有成本效益的管理方法。共有98%的医生同意，低成本达格列净因其代谢益处、心脏保护、肾脏保护和潜在的成本效益而具有理想SGLT2i的特征。结论 这项基于调查的研究表明，达格列净对T2DM及并发症患者是一种有效且节省成本的治疗方法。低成本达格列净可彻底改变印度T2DM的治疗方式。
