Yousefi Nazila, Hemmati Fatemeh, Jaddi Zeinab Sadat, Salamzadeh Jamshid
Department of Pharmacoeconomics and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Diabetes Metab Disord. 2022 Feb 16;21(1):361-367. doi: 10.1007/s40200-022-00983-8. eCollection 2022 Jun.
According to the world health organization (WHO), by the year 2030 diabetes will become the world's seventh leading cause of death. This study aimed to design and conduct a descriptive pharmacoepidemiological investigation of anti-diabetic drugs utilization during a ten-year period using the anatomical therapeutic classification/defined daily dose (ATC / DDD) system in Iran.
Based on pharmaceutical wholesalers' sale reports, sale data, including value and volume, were retrieved from the Iranian Annual Pharma Statistics for 2009-2018. The ATC/DDD system was used to standardize the raw sales data. Anti-diabetic drug utilization was reported as DDD per 1000 person in the population per day. Expenditure was calculated as USD per DDD. Results were then analyzed descriptively.
During the ten-year study period, total anti-diabetic drug consumption increased by 235.53%. Insulin utilization grew by 148.65%, whereas non-insulin agents' use showed a 132.68% increase. Anti-diabetic drugs' expenditure increased by almost 9-fold, but changes were accompanied with many fluctuations. Although the absolute expenditure of almost all classes of anti-diabetic drugs were increasing, this growth was greater in biguanides, which only includes metformin in Iran. Approximately one-third of anti-diabetic drugs expenditures were related to fast-acting insulins. Imported drugs share in cost was significant, but not in consumption. The overall share of insulin consumption was less than 19%, but their share of total value reached 60% of the anti-diabetic market.
The growing trend in both insulin and non-insulin anti-diabetic drugs utilization is a substantial issue for health authorities' policy making for sustainable access to medicine.
根据世界卫生组织（WHO）的数据，到2030年糖尿病将成为全球第七大死因。本研究旨在利用解剖治疗学分类/限定日剂量（ATC/DDD）系统，对伊朗十年间抗糖尿病药物的使用情况进行描述性药物流行病学调查。
根据药品批发商的销售报告，从《2009 - 2018年伊朗年度药品统计数据》中获取包括价值和数量在内的销售数据。使用ATC/DDD系统对原始销售数据进行标准化。抗糖尿病药物的使用情况以每1000人每天的限定日剂量（DDD）来报告。支出以每DDD的美元数计算。然后对结果进行描述性分析。
在十年的研究期内，抗糖尿病药物的总消费量增长了235.53%。胰岛素的使用量增长了148.65%，而非胰岛素类药物的使用量增长了132.68%。抗糖尿病药物的支出增长了近9倍，但变化伴随着许多波动。尽管几乎所有类别的抗糖尿病药物的绝对支出都在增加，但在伊朗仅包含二甲双胍的双胍类药物中这种增长更为显著。大约三分之一的抗糖尿病药物支出与速效胰岛素有关。进口药物在成本中所占份额显著，但在消费量中并非如此。胰岛素消费的总体份额不到19%，但其在总价值中的份额达到了抗糖尿病市场的60%。
胰岛素和非胰岛素抗糖尿病药物使用量的增长趋势，对于卫生当局制定可持续获取药物的政策来说是一个重大问题。
