Hamblin Peter S, Earnest Arul, Russell Anthony W, Talic Stella, Zomer Ella, Zoungas Sophia
School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
Department of Endocrinology & Diabetes, Alfred Health, Commercial Road, Melbourne, VIC 3004, Australia.
Lancet Reg Health West Pac. 2024 Sep 24;52:101207. doi: 10.1016/j.lanwpc.2024.101207. eCollection 2024 Nov.
Global insulin requirements for type 2 diabetes were predicted to increase by more than 20% from 2018 to 2030. However, this did not anticipate the rapid increase in use of glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors that has occurred over recent years. The current study aims to examine changes in insulin utilisation and costs in Australia from 2003 to 2023.
We conducted a large-scale observational study of national insulin utilisation and expenditure in Australia from 2003 to 2023 using the Australian Pharmaceutical Benefits Scheme. The proportion of insulin-treated people with type 2 diabetes between 2013 and 2023 was estimated using National Diabetes Services Scheme data. Joinpoint models and interrupted time series analysis were used to examine utilisation trends.
Insulin utilisation (units of insulin per person with diabetes) increased by an average of 2.71% per annum (95% CI 1.97, 3.73) from 2003 to 2015, then fell by 2.70% per annum (95% CI -4.55, -1.39) from 2015 to 2023. The proportion of insulin-treated people with type 2 diabetes increased by 1.00% per annum (95% CI 0.81, 1.25) from 2013 to 2020, then fell by 0.66% per annum (95% CI -1.62, -0.04) from 2020 to 2023. A 43% reduction in inflation-adjusted insulin expenditure was observed between 2015 and 2023 due to a combination of reduced utilisation and reduction in the price of insulin glargine.
Projected global insulin requirements and costs may be less than previously anticipated if reduced use of insulin in Australia is similarly observed in other countries.
No funding was received for this study.
预计2018年至2030年全球2型糖尿病胰岛素需求量将增长超过20%。然而，这并未预料到近年来胰高血糖素样肽-1受体激动剂和钠-葡萄糖协同转运蛋白2抑制剂的使用迅速增加。本研究旨在考察2003年至2023年澳大利亚胰岛素使用情况和成本的变化。
我们利用澳大利亚药品福利计划对2003年至2023年澳大利亚全国胰岛素使用情况和支出进行了大规模观察性研究。使用国家糖尿病服务计划数据估算2013年至2023年接受胰岛素治疗的2型糖尿病患者比例。采用连接点模型和中断时间序列分析来考察使用趋势。
2003年至2015年，胰岛素使用量（糖尿病患者人均胰岛素使用单位）年均增长2.71%（95%CI 1.97, 3.73），然后在2015年至2023年期间年均下降2.70%（95%CI -4.55, -1.39）。2013年至2020年，接受胰岛素治疗的2型糖尿病患者比例年均增长1.00%（95%CI 0.81, 1.25），然后在2020年至2023年期间年均下降0.66%（95%CI -1.62, -0.04）。由于胰岛素使用量减少和甘精胰岛素价格降低，2015年至2023年经通胀调整后的胰岛素支出减少了43%。
如果其他国家也出现澳大利亚那样胰岛素使用量减少的情况，那么预计的全球胰岛素需求量和成本可能低于此前预期。
本研究未获得资金支持。
