Hasan Syed Shahzad, Aslam Qasim, Islam Imarah, Kow Chia Siang, Babar Zaheer Ud Din
Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom.
Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom.
Prim Care Diabetes. 2022 Apr;16(2):271-278. doi: 10.1016/j.pcd.2022.01.008. Epub 2022 Feb 1.
There has been an increase in prescribing and costs of oral hypoglycaemic agents in England and other countries. This study aims to investigate the trends in prescriptions, costs, and adverse events of metformin and metformin-based single pill drug combinations from 2015 to 2020 and explore why changes in use or cost are occurring.
Prescriptions and costs data from Prescription Cost Analysis database and Interactive Drug Analysis Profiles presenting all suspected ADRs reported for each drug were examined. Pharmacy level prices were also obtained. Linear regression analysis was used to investigate the trends in prescribing and costs.
Prescribing and costs of metformin-based single pill drug combinations (as a percent mean change per year) saw an increase of 8.78% (95% Cl: 7.45%, 10.11%, p = 0.001) and 5.17% (95% Cl: 2.13%, 8.22%, p = 0.009) on average each year, respectively. Metformin was the most prescribed monotherapy drug between 2015 and 2020. The cost of prescribing metformin (as a proportion of total oral hypoglycaemic agents) has been reduced from 30% in 2015 to 17% in 2020. Metformin-dipeptidyl peptidase-4 inhibitor (e.g., metformin-sitagliptin) combination was the most popular metformin-based single pill drug combination. The number of adverse drug reactions per million items dispensed shows that metformin has the lowest adverse drug reactions per million items compared to other oral hypoglycaemic drugs.
Overall, an increase in prescription items can be seen for metformin-based single pill drug combinations along with an increase in their costs in primary care in England between 2015 and 2020. There was a declining trend for the number of ADRs reported per million prescription items dispensed for metformin-containing single pill combinations, even though their prescription rate increased.
在英国和其他国家，口服降糖药的处方量和成本均有所增加。本研究旨在调查2015年至2020年二甲双胍及基于二甲双胍的单片复方制剂的处方、成本及不良事件趋势，并探究使用情况或成本发生变化的原因。
检查了来自处方成本分析数据库的处方和成本数据，以及呈现每种药物报告的所有疑似药品不良反应的交互式药物分析概况。还获取了药房层面的价格。采用线性回归分析来研究处方和成本趋势。
基于二甲双胍的单片复方制剂的处方量（每年平均变化百分比）和成本分别平均每年增加8.78%（95%置信区间：7.45%，10.11%，p = 0.001）和5.17%（95%置信区间：2.13%，8.22%，p = 0.009）。二甲双胍是2015年至2020年处方量最多的单一疗法药物。二甲双胍的处方成本（占口服降糖药总成本的比例）已从2015年的30%降至2020年的17%。二甲双胍-二肽基肽酶-4抑制剂（如二甲双胍-西他列汀）组合是最受欢迎的基于二甲双胍的单片复方制剂。每百万剂次分发的药品不良反应数量显示，与其他口服降糖药相比，二甲双胍每百万剂次的药品不良反应最少。
总体而言，2015年至2020年期间，英国基层医疗中基于二甲双胍的单片复方制剂的处方量有所增加，成本也随之上升。尽管含二甲双胍的单片复方制剂的处方率有所上升，但每百万剂次分发的含二甲双胍单一药丸组合报告的药品不良反应数量呈下降趋势。
