Csatordai Márta, Benkő Ria, Matuz Mária, Engi Zsófia, Csupor Dezső, Lengyel Csaba, Doró Péter
Faculty of Pharmacy, Institute of Clinical Pharmacy, University of Szeged, Szikra utca 8, 6725, Szeged, Hungary.
Albert Szent-Györgyi Health Centre, Central Pharmacy, University of Szeged, Szeged, Hungary.
Diabetol Metab Syndr. 2024 Apr 24;16(1):88. doi: 10.1186/s13098-024-01334-8.
The prevalence of diabetes is increasing, and several new drug groups have been authorized and used successfully in the treatment of diabetes, while older drug groups are still in use. Our aim was to assess the utilization tendencies and regional differences in antidiabetic medication consumption in Hungary between 2015 and 2021 and to identify the possible determinants of regional differences in antidiabetic medication use.
For this retrospective drug utilization study, yearly wholesale database was used, which provides total coverage for ambulatory antidiabetic drug sales in Hungary, including both reimbursed and non-reimbursed medications. Data were expressed as Defined Daily Dose per 1000 inhabitants per day (DDD/TID), percentage of total use and the ratio of the highest and lowest utilization values among the counties (max/min ratio). To assess the potential reasons for regional differences in antidiabetic drug use, we analyzed the associations between regional drug utilization data and possible determinants.
The total national antidiabetic medication use has increased by 7.6% and reached 94.8 DDD/TID in 2021. Regarding antidiabetic subgroups, the use of metformin and novel antidiabetics (DPP4Is, GLP1As and SGLT2Is) and their combinations increased in all counties, while sulfonylurea consumption decreased, and insulin use was stable. In 2021, 19.2-24.1% of the total antidiabetic medication consumption was novel antidiabetics, 39.1-47.2% metformin, 14.8-25.8% sulfonylureas and 23.6-30.5% were insulins. Regional differences in antidiabetic medication consumption were considerable mainly in the case of GLP1As (max/min ratio:3.00), sulfonylureas (2.03) and SGLT2Is (1.92) in 2021. The association between antidiabetic medication use and possible determinants was confirmed in the case of unemployment rate and sulfonylurea use, the number of public medical card holders per ten thousand inhabitants and human insulin and sulfonylurea use. GLP1As were the only antidiabetic drug group that did not correlate with any of the investigated factors.
Although novel antidiabetic drug use was growing dynamically in Hungary, sulfonylurea use is still considerable. Differences in antidiabetic drug consumption were substantial between the regions.
糖尿病的患病率正在上升，几种新药组已被批准并成功用于糖尿病治疗，而旧药组仍在使用。我们的目的是评估2015年至2021年匈牙利抗糖尿病药物消费的使用趋势和地区差异，并确定抗糖尿病药物使用地区差异的可能决定因素。
对于这项回顾性药物利用研究，使用了年度批发数据库，该数据库全面涵盖了匈牙利门诊抗糖尿病药物的销售情况，包括报销和非报销药物。数据以每1000居民每天的限定日剂量（DDD/TID）、总使用量的百分比以及各县最高和最低使用值的比率（最大/最小比率）表示。为了评估抗糖尿病药物使用地区差异的潜在原因，我们分析了地区药物利用数据与可能的决定因素之间的关联。
2021年全国抗糖尿病药物的总使用量增加了7.6%，达到94.8 DDD/TID。关于抗糖尿病药物亚组，所有县二甲双胍和新型抗糖尿病药物（二肽基肽酶4抑制剂、胰高血糖素样肽1类似物和钠-葡萄糖协同转运蛋白2抑制剂）及其组合的使用量均增加，而磺脲类药物的消费量下降，胰岛素使用量稳定。2021年，抗糖尿病药物总消费量的19.2% - 24.1%为新型抗糖尿病药物，39.1% - 47.2%为二甲双胍，14.8% - 25.8%为磺脲类药物，23.6% - 30.5%为胰岛素。2021年抗糖尿病药物消费的地区差异主要体现在胰高血糖素样肽1类似物（最大/最小比率：3.00）、磺脲类药物（2.03）和钠-葡萄糖协同转运蛋白2抑制剂（1.92）方面。抗糖尿病药物使用与可能的决定因素之间的关联在失业率与磺脲类药物使用、每万居民公共医疗卡持有者数量与人类胰岛素和磺脲类药物使用方面得到证实。胰高血糖素样肽1类似物是唯一与任何调查因素均无关联的抗糖尿病药物组。
尽管匈牙利新型抗糖尿病药物的使用量在动态增长，但磺脲类药物的使用量仍然可观。各地区抗糖尿病药物消费存在显著差异。
