Diabetes is one of the biggest world heath problem with the prevalence of around 10 %. A little more than 105000 people received type 2 diabetes medications in 2015. 28,3 million euros for diabetic medicines and 16,2 million euros for diabetic medical devices were used the same year. The purpose of our work is an overview of market dynamics of medicines for type 2 diabetes treatment between 2006 and 2017, among which metformin, sulfonylurea, DPP-4 (dipeptidyl peptidase 4) inhibitors, glinide, GLP-1 (Glucagon-like peptide-1) analogues, SGLT-2 (sodium/glucose cotransporter 2) inhibitors, α glucosidase inhibitors and glitazones were considered. Data from Medicinal products database, List of interchangeable medicinal products, Database of dispensed prescription medicines on expenses of health insurance, Health claims data on prescription drugs obtained from the Health Insurance Institute of Slovenia were obtained. In the beginning, a set of medicines prescribed between 2006 and 2017 were defined. The medicines were given market shares based on prescribed defined daily doses. Regulated and actual prices of medicines were converted to the values of month consumption. We also calculated chain price indexes of medicine groups.
Sulfonylureas were the most prescribed group between 2006 and 2015. However, metformin was increasing its shares due to Slovenian guidelines for type 2 diabetes treatment recommendations which claims for it to be the first line medicine. Among sulfonylureas, gliclazide shares increased because of its cardiovascular benefits. DPP-4 inhibitors became the 3rd most prescribed group because they don’t cause hypoglycemia. Gliptines are meant for a specific diabetics population, so their shares were not bigger than 5 %. GLP-1 analogues are expensive drugs for subcutaneous application with shares below 2 %. SGLT-2 inhibitors are the most recent drugs that hit the market in 2014. Their shares remained below 1 %. The decrease was caused by new generic medicines in case of metformin, sulfonylureas and gliptines (40-70 % decrease). Similar effect occured in case of DPP-4 inhibitors, GLP-1 analogs and SGLT-2 inhibitors due to new similar drugs or combinations (10-40 % decrease). Actual prices were lower than regulated ones, at most in case of SGLT-2 inhibitors (for 30 %) and metformin and glinides (for around 20 %). Prices depended on the amount of the drug itself in the case of metformin, but not in the case of gliclazide, glimepiride and repaglinide. Addition of metformin to DPP-4 inhibitors did not add any value to the price of a medicine. Chain price indexes represented general year-to-year decrease of both regulated and actual prices, especially due to arrival of new generic medicines, similar drugs and definition of new lists of interchangeable medicinal products. Groups of medicines with lower average prices were in general also prescribed more (DPP-4 inhibitors excluded).
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