Department of Pharmacy Practice, School of Pharmacy, Kuwait University, Jabriyah, Kuwait.
Department of Health Policy and Management, School of Public Health, Kuwait University, Jabriyah, Kuwait.
PLoS One. 2022 Jun 2;17(6):e0268495. doi: 10.1371/journal.pone.0268495. eCollection 2022.
Diabetes imposes a large burden on countries' healthcare expenditures. In Kuwait, diabetes prevalence in adults is estimated at 22.0%%-double the worldwide prevalence (9.3%). There is little current data on pharmaceutical costs in Kuwait of managing diabetes and diabetes-related complications and comorbidities.
Estimate the utilization and cost of drugs for diabetes and diabetes-related complications and comorbidities in Kuwait for year 2018, as well determinants of costs.
This cross-sectional study used a multi-stage stratified sampling method. Patients were Kuwaiti citizens with diabetes, aged 18-80, recruited from all six governorates. Physicians collected demographic data, clinical data, and current drug prescription for each patient which was extrapolated for the full year of 2018. A prevalence-based approach and bottom-up costing were used. Data were described according to facility type (primary care vs. hospital). A generalized linear model with log function and normal distribution compared drug costs for patients with and without comorbidities/complications after adjustments for demographic and health confounders (gender, age group, disease duration, and obesity).
Of 1182 diabetes patients, 64.0% had dyslipidemia and 57.7% had hypertension. Additionally, 40.7% had diabetes-related complications, most commonly neuropathy (19.7%). Of all diabetes patients, 85.9% used oral antidiabetics (alone or in combinations), 49.5% used insulin alone or in combinations, and 29.3% used both oral antidiabetics and insulin. The most frequently used oral drug was metformin (75.7%), followed by DPP4 inhibitors (40.2%) and SGLT2 inhibitors (23.8%). The most frequently used injectables were insulin glargine (36.6%), followed by GLP-1 receptor agonists (15.4%). Total annual drug cost for Kuwait's diabetic population for year 2018 was US$201 million (US$1,236.30 per patient for antidiabetics plus drugs for comorbidities/complications).
Drug costs for treating diabetes and comorbidities/complications accounted for an estimated 22.8% of Kuwait's 2018 drug expenditures. Comorbidities and complications add 44.7% to the average drug cost per diabetes patient.
糖尿病给各国的医疗保健支出带来了巨大负担。在科威特，成年人的糖尿病患病率估计为 22.0%——是全球患病率（9.3%）的两倍。目前，关于科威特治疗糖尿病及其相关并发症和合并症的药物成本数据很少。
估算 2018 年科威特治疗糖尿病和糖尿病相关并发症和合并症的药物使用情况和成本，以及成本的决定因素。
这项横断面研究采用多阶段分层抽样方法。从六个省招募了年龄在 18-80 岁的患有糖尿病的科威特公民作为患者。医生收集了每位患者的人口统计学数据、临床数据和当前的药物处方，这些数据被推断为 2018 年全年的情况。采用基于患病率的方法和自下而上的成本核算。根据医疗机构类型（基层医疗保健与医院）对数据进行描述。使用对数函数和正态分布的广义线性模型，比较患有和不患有合并症/并发症的患者的药物费用，同时调整人口统计学和健康混杂因素（性别、年龄组、疾病持续时间和肥胖）。
在 1182 名糖尿病患者中，64.0%有血脂异常，57.7%有高血压。此外，40.7%有糖尿病相关并发症，最常见的是神经病变（19.7%）。所有糖尿病患者中，85.9%使用口服抗糖尿病药物（单独或联合使用），49.5%使用胰岛素单独或联合使用，29.3%同时使用口服抗糖尿病药物和胰岛素。使用最频繁的口服药物是二甲双胍（75.7%），其次是 DPP4 抑制剂（40.2%）和 SGLT2 抑制剂（23.8%）。使用最频繁的注射剂是胰岛素甘精（36.6%），其次是 GLP-1 受体激动剂（15.4%）。2018 年科威特糖尿病患者的年药物总费用为 2.01 亿美元（每位患者的抗糖尿病药物加合并症/并发症药物费用为 1236.30 美元）。
治疗糖尿病及其合并症/并发症的药物费用占科威特 2018 年药物支出的估计 22.8%。合并症和并发症使每位糖尿病患者的平均药物费用增加了 44.7%。
