Highlights
- •Guideline recommended initial antidiabetic agents were significantly less costly.
- •Self-monitoring of blood glucose (SMBG) resulted in 80% higher prescription costs.
- •High frequency SMBG did not differ by initial antidiabetic agent.
Abstract
Aims
To measure the costs associated with the use of antidiabetic agents, monitoring materials
and cardiovascular disease (CVD) agents in the management of newly treated type 2
diabetes, and to investigate the factors associated with these costs.
Methods
A population-based retrospective cohort study was conducted using the Irish national
pharmacy claims database. Newly treated patients were identified for 2012 and followed
for one year post treatment initiation. Factors associated with costs were assessed
using a generalised linear model with gamma family and log-link function. Cost ratios
(CR) and 95% CIs were used to determine the contributors of prescription costs. Adjusted
odd ratios (OR) and 95% CIs were used to investigate factors associated with high
frequency self-monitoring of blood glucose (SMBG).
Results
Mean prescription costs for the 12,941 subjects was €871, while total costs were €11
million. CVD agents accounted for 58% of total costs; 22% of costs were for SMBG;
antidiabetic agents accounted for 17% of costs. SMBG resulted in costs that were 80%
higher than those without, CR 1.80 (95% CI 1.76–1.84). No significant differences
were observed between initiation on metformin or sulphonylureas and high frequency
SMBG (OR 1.01 95% CI 0.97–1.04 vs reference). Initiation on newer antidiabetic agents
was a significant positive predictors of prescription costs (CR 2.36 95% CI 2.21–2.51
vs metformin).
Conclusions
Type of initial antidiabetic agent, and SMBG were significant predictors of prescription
costs. SMBG represent a major proportion of total costs; however, its use in combination
with antidiabetic agents that do not cause hypoglycaemia is questionable.
Keywords
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Article info
Publication history
Published online: January 12, 2016
Accepted:
December 26,
2015
Received in revised form:
November 28,
2015
Received:
October 20,
2015
Identification
Copyright
© 2016 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
