DOI: https://doi.org/10.24959/nphj.18.2214

The study of the effectiveness of the combined therapy of diabetes mellitus based on the pharmacoeconomic analysis in Ukraine

T. A. Germanyuk, T. I. Ivko, L. A. Bobrytskaia

Abstract


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.


Keywords


diabetes mellitus; ATC / DDD methodology; cost-effectiveness analysis

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