The study of the effectiveness of the combined therapy of diabetes mellitus based on the pharmacoeconomic analysis in Ukraine
Keywords:diabetes mellitus, ATC / DDD methodology, cost-effectiveness analysis
Diabetes mellitus (DM) is a national health priority in the world and in Ukraine too.
Aim. To substantiate the choice of regimens for combined therapy of type 2 DM (T2DM).
Materials and methods. The research materials were retrospective analysis of 1792 medical histories of the inpatients with T2DM. These patients were treated in the endocrinology clinics of the Podolsky region of Ukraine. The methods of frequency analysis; ATC/DDD-methodology; cost-effectiveness analysis were used. The cost of a defined daily dose (DDD) of drugs was studied in UAH according to the data of the average retail price of drugs in Ukraine as of May 2017.
Results and discussion. The frequency analysis showed that the monotherapy with metformin, glimepiride and gliclazide was used in 25 % of cases, and combined therapy with metformin + glimepiride, metformin + gliclazide and metformin + glibenclamide was used in 66 % of cases when treating T2DM. It was found that inpatients with metformin + glibenclamide regimen were significantly older, with the longer duration of T2DM, with the highest body mass index and highest levels of fasting plasma glucose (FPG). When comparing inpatients with metformin + gliclazide regimen and metformin + glimepiride regimen a significant difference between the duration of the disease and the level of FPG on admission was determined, no other significant differences were found by other parameters analyzed. The ATC/DDDmethodology showed that metformin + glimepiride regimen had the minimum cost of DDD, and metformin + gliclazide regimen had the maximum cost of DDD. The cost-effectiveness analysis showed that the costs-efficiency ratio (CER) for metformin + glibenclamide regimen varies from 560.10 to 2138.49 UAH, for metformin + glimepiride – from 821.07 to 2300.20 UAH, for metformin + gliclazide – from 798.65 to 2128.60 UAH in the context of minimal and maximal prices of generics.
Conclusions. The frequency analysis showed that the combined therapy of T2DM was used in 66 % of cases. It was found that patients with metformin + glibenclamide regimen were significantly older, they had a longer duration of T2DM, the highest BMI and the highest levels of FPG. The regimen of the combined therapy with metformin + glibenclamide has the cost-effective advantages compared to other treatment regimens.
ATC/DDD Index. (2017). whocc.no. Available at: http://www.whocc.no
Boychuk, T. M., Tolstanov, D. C., Grytsiuk, M. I., Gozhenko, A. I. (2013). Glycated proteins in diabetes:the phenomenon of formation
and pathogenetic effects (review). Actual problems of transport medicine, 3, 52-59.
Ogurtsova, K., da Rocha Fernandes, J. D., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N. H., … Makaroff, L. E. (2017). IDF Diabetes
Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Research and Clinical Practice, 128, 40–50.
Nakaz MOZ Ukrainyvid 21.12.2012 r. № 1118. (2012). Unifikovany i klinichnyi protokol pervynnoi ta vtorynnoi (spetsializovanoi)
medychnoi dopomohy. Available at: https://www.moz.gov.ua/docfiles/dod1118_2_2012.pdf
Iagudina, R. I., Kulikov, A. Iu., Arinina, E. E. (2011). Farmako ekonomika sakharnogo diabeta vtorogo tipa. Moscow: OOO “Meditcinskoe
informatcionnoe agentstvo”, 352.
Hermaniuk, T. A., Ivko, T. I. (2014). Metodolohiia marketynhovykh, farmako epidemiolohichnykh ta farmakoekonomichnykh doslidzhen
u farmatsii: metod. vkaz. Vinnytsia: Nilan-LTD, 64.
Copyright (c) 2018 National University of Pharmacy
This work is licensed under a Creative Commons Attribution 4.0 International License.Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).