National trends in anti-diabetic treatment in Taiwan, 2000-2009.
J Formos Med Assoc
; 111(11): 617-24, 2012 Nov.
Article
in En
| MEDLINE
| ID: mdl-23217597
ABSTRACT
BACKGROUND/PURPOSE:
The impact of the introduction of newer anti-diabetic agents on the treatment pattern in the booming diabetic population remains unclear. We examined the patterns and temporal trends of anti-diabetic drug use in Taiwan, with particular emphasis on combination therapy.METHODS:
We searched the Taiwan National Health Insurance Database during 2000-2009 to identify outpatient prescriptions of anti-diabetic drugs, including human insulins and insulin analogues, sulfonylureas, glinides, metformin, thiazolidinediones, alpha-glucosidase inhibitors, and dipeptidyl peptidase-4 inhibitors. Glucose-lowering treatments were classified according to pattern (oral agents only, insulins only, and oral agents and insulins combined) and a number of different classes of anti-diabetic drugs. Insulin therapy and combination therapy with two oral anti-diabetic drugs (OAD) were further classified according to individual drug combination patterns.RESULTS:
Although metformin remained the mainstay of anti-diabetic treatment, patients receiving combination therapy of oral glucose-lowering agents, either with or without insulin, significantly increased, from approximately 40% in 2000 to 60% in 2009, particularly in relation to the newer agents, including glinides, alpha-glucosidase inhibitors, and long-acting insulin analogues. Use of sulfonylureas and thiazolidinediones decreased substantially. For insulin therapy, the most commonly prescribed drugs were premix insulin analogues and basal insulin analogues, accounting for one-third of total insulin prescriptions in 2009.CONCLUSION:
We found an increasing complexity of anti-diabetic therapy during the past decade in Taiwan. Further studies are needed to evaluate whether this treatment pattern will lead to improved clinical outcomes in terms of cost-effectiveness.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Registries
/
Drug Costs
/
Diabetes Mellitus
/
Hypoglycemic Agents
Limits:
Adult
/
Humans
Country/Region as subject:
Asia
Language:
En
Journal:
J Formos Med Assoc
Journal subject:
MEDICINA
Year:
2012
Type:
Article
Affiliation country:
Taiwan