DRUG PRESCRIBING PATTERN AND COST-EFFECTIVENESS ANALYSIS OF ORAL ANTIDIABETIC DRUGS IN PATIENTS WITH TYPE-2 DIABETES MELLITUS: REAL-WORLD DATA FROM INDIAN POPULATION.

Authors

  • GHADAH SALIM MUSSTTAF Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India.
  • ANWAR HABIB Department of Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India.
  • MARWAN MAHTOOK Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India.

DOI:

https://doi.org/10.22159/ajpcr.2021.v14i7.41677

Keywords:

Diabetic control, Drug utilization, Pharmacoeconomics, Oral antidiabetic drug, Prescribing trends

Abstract

Objectives: The objective of the study was to evaluate the drug prescribing pattern and pharmacoeconomics of oral diabetic medications in patients of type 2 diabetes mellitus visiting the medicine OPD of HAH Centenary Hospital, Jamia Hamdard, New Delhi.

Methods: Observational study conducts on 100 T2DM patients to assess their demographics and individual details such as disease history, BMI, and economic status along with the drug utilization assessment and cost-effectiveness analysis of prescribed drugs.

Results: Among 100 patients, 40 (40%) were male, and 60 (60%) were female, indicating that T2DM is slightly more prevalent in females. The mean age of the subjects included in the study is 51.46 years. Of the total number of patients, 64 were under oral antidiabetic drugs, and remaining were pregnant females under insulin. The majority of the subjects, 69.4%, were on multiple drug therapy and remaining treated with monotherapy. Metformin 500 mg (32.81%) was the most prescribed oral antidiabetic drug followed by glimepiride 4 mg (15.62%) and 12.5% for glimepiride 2 mg + metformin 500 mg, sitagliptin + metformin 50/500, and vildagliptin 50 + metformin 850, respectively. The maximum mean reduction of FBG was seen with glimepiride 4 mg (34.69 mg/dl) and lowest with metformin 500 mg (24.05 mg/dl). The cost per unit (1 mg/dl) reduction in FBG (ACER) was highest with sitagliptin 50 mg (INR 63.14) and lowest with glimepiride 1 mg + metformin 500 mg (INR 9.95).

Conclusion: Most type 2 diabetic patients in this setting were treated with multiple oral antidiabetic therapies. Metformin and sitagliptin were the most common choice as monotherapy agents. CEA concludes that the cost associated with diabetes is enormous and varies greatly. The combination therapy of glimepiride 2 mg + metformin 500 mg was the most cost effective.

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References

Khan MA, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of Type 2 diabetes-global burden of disease and forecasted trends. J Epidemiol Glob Health 2020;10:107-111. DOI: https://doi.org/10.2991/jegh.k.191028.001

Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc 2011;86:304-14. DOI: https://doi.org/10.4065/mcp.2010.0575

Chaudhury A, Duvoor C, Dendi VS, Kraleti S, Chada A, Ravilla R, et al. Clinical review of antidiabetic drugs: Implications for Type 2 diabetes mellitus management. Front Endocrinol (Lausanne) 2017;8:6. DOI: https://doi.org/10.3389/fendo.2017.00006

Tamilselvan T, Kumutha T, Lekshmi A, James A, Reji J, Cheriyan N. Pharmacoeconomical evaluation of oral hypoglycemic agents for Type-2 diabetes mellitus in a multispeciality hospital. Int J Pharm Sci Res 2017;8:2243-8.

Maiti R, Bhatia V, Padhy BM, Hota D. Essential medicines: An Indian perspective. Indian J Community Med 2015;40:223-32. DOI: https://doi.org/10.4103/0970-0218.164382

Bosworth HB, Granger BB, Mendys P, Brindis R, Burkholder R, Czajkowski SM, et al. Medication adherence: A call for action. Am Heart J 2011;162:412-24. DOI: https://doi.org/10.1016/j.ahj.2011.06.007

Pradeepa R, Mohan V. Changing scenario of the diabetes epidemic. Implications for India. Ind J Med Res 2002;116:121-32.

Jain A, Paranjape S. Prevalence of Type 2 diabetes mellitus in elderly in a primary care facility: An ideal facility. Indian J Endocrinol Metab 2013;17:S318-22. DOI: https://doi.org/10.4103/2230-8210.119647

Gupta S, Bansal S. Does a rise in BMI cause an increased risk of diabetes?: Evidence from India. PLoS One 2020;15:e0229716. DOI: https://doi.org/10.1371/journal.pone.0229716

Wu Y, Ding Y, Tanaka Y, Zhang W. Risk factors contributing to Type 2 diabetes and recent advances in the treatment and prevention. Int J Med Sci 2014;11:1185-200. DOI: https://doi.org/10.7150/ijms.10001

Chandra P, Gogate B, Gogate P, Thite N, Mutha A, Walimbe A. Economic burden of diabetes in urban Indians. Open Ophthalmol J 2014;8:91-4. DOI: https://doi.org/10.2174/1874364101408010091

Lv Z, Guo Y. Metformin and its benefits for various diseases. Front Endocrinol (Lausanne) 2020;11:191. DOI: https://doi.org/10.3389/fendo.2020.00191

Alex SM, Sreelekshmi BS, Smitha S, Jiji KN, Menon AS, Devi UP. Drug utilization pattern of antidiabetic drugs among diabetic outpatients in a tertiary care hospital. Asian J Pharm Clin Res 2015;8:144-6.

Marín-Peñalver JJ, Martín-Timón I, Sevillano-Collantes C, Del Cañizo-Gómez FJ. Update on the treatment of Type 2 diabetes mellitus. World J Diabetes 2016;7:354-95. DOI: https://doi.org/10.4239/wjd.v7.i17.354

Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycaemia in Type 2 diabetes: A patient-centered approach. Position statement of the American diabetes association (ADA) and the European association for the study of diabetes (EASD). Diabetologia 2012;55:1577-96. DOI: https://doi.org/10.1007/s00125-012-2534-0

American Diabetes Association. Approaches to glycemic treatment. Diab Care 2016;39:52-9. DOI: https://doi.org/10.2337/dc16-S010

Kim HS, Kim DM, Cha BS, Park TS, Kim KA, Kim DL, et al. efficacy of glimepiride/metformin fixed-dose combination vs metformin uptitration in Type 2 diabetic patients inadequately controlled on low-dose metformin monotherapy: A randomized, open label, parallel group, multicenter study in Korea. J Diabetes Investig 2014;5:701-8. DOI: https://doi.org/10.1111/jdi.12201

Arechavaleta R, Seck T, Chen Y, Krobot KJ, Neill EA, Duran L, et al. efficacy and safety of treatment with sitagliptin or glimepiride in patients with Type 2 diabetes inadequately controlled on metformin monotherapy: A randomized, double-blind, noninferiority trial. Diabetes Obes Metab 2011;13:160-8. DOI: https://doi.org/10.1111/j.1463-1326.2010.01334.x

Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and Type 2 diabetes: The American college of sports medicine and the American diabetes association: Joint position statement. Diabetes Care 2010;33:e147-67. DOI: https://doi.org/10.2337/dc10-9990

Jafarian-Amirkhizi A, Sarayani A, Gholami K, Taghizadeh-Ghehi M, Heidari K, Jafarzadeh-Kohneloo A, et al. Adherence to medications, self-care activity, and HbA1c status among patients with Type 2 diabetes living in an urban area of Iran. J Diabetes Metab Disord 2018;17:165-72. DOI: https://doi.org/10.1007/s40200-018-0356-4

Abdelaziz MS, Rani HS, Ravindranath S, Shaik R, Kasim M, Salam AA. Pharmacoeconomic evaluation of oral-hypoglycemic agents at hospital in Bangalore. IOSR J Pharm Biol Sci 2015;10:46-50.

Basit A, Riaz M, Fawwad A. Glimepiride: Evidence-based facts, trends, and observations (GIFTS). Vasc Health Risk Manag 2012;8:463-72. DOI: https://doi.org/10.2147/VHRM.S33194

Acharya KG, Shah KN, Solanki ND, Rana DA. Evaluation of antidiabetic prescriptions, cost and adherence to treatment guidelines: A prospective, cross-sectional study at a tertiary care teaching hospital. J Basic Clin Pharma 2013;4:82-7. DOI: https://doi.org/10.4103/0976-0105.121653

Grover S, Avasthi A, Bhansali A, Chakrabarti S, Kulhara P. Cost of ambulatory care of diabetes mellitus: A study from north India. Postgrad Med J 2005;81:391-5. DOI: https://doi.org/10.1136/pgmj.2004.024299

Published

07-07-2021

How to Cite

MUSSTTAF, G. S., A. HABIB, and M. MAHTOOK. “DRUG PRESCRIBING PATTERN AND COST-EFFECTIVENESS ANALYSIS OF ORAL ANTIDIABETIC DRUGS IN PATIENTS WITH TYPE-2 DIABETES MELLITUS: REAL-WORLD DATA FROM INDIAN POPULATION”. Asian Journal of Pharmaceutical and Clinical Research, vol. 14, no. 7, July 2021, pp. 45-49, doi:10.22159/ajpcr.2021.v14i7.41677.

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