Vnitr Lek 2015, 61(Suppl 3):25-29

Analysis of the development of metformin and sulfonylurea prescriptions in the Czech Republic

Denisa Janíčková-Žďárská^1,*, Petr Honěk², Ladislav Dušek^3,4, Tomáš Pavlík^3,4, Milan Kvapil¹

¹ Interní klinika 2. LF UK a FN Motol, Praha, přednosta prof. MUDr. Milan Kvapil, CSc., MBA

² Všeobecná zdravotní pojišťovna České republiky, Praha, ředitel Ing. Zdeněk Kabátek

³ Ústav zdravotnických informací a statistiky, Praha, ředitel doc. RNDr. Ladislav Dušek, Ph.D.

⁴ Institut biostatistiky a analýz MU Brno, ředitel doc. RNDr. Ladislav Dušek, Ph.D.

Introduction:
In the Czech Republic, patients with diabetes mellitus (DM) are followed and treated predominantly by specialists (approx. 80% at a specialist diabetology clinic), a minor part by general practitioners (up to 20%). Long-term development of the changes in prescribing metformin and sulfonylurea in the Czech Republic and its concordance with recommended procedures has not been evaluated until now.


Goal:
Comparison of the development of metformin (MET) and sulfonylurea (SU) prescriptions in the period of 2002-2006 with that of 2010-2014 in a representative sample of the patient population with DM kept in the database of the General Health Insurance Company of the Czech Republic (VZP) which provided health care coverage for 63% of Czech Republic population in 2014.

Methodology:
We identified all individuals in the VZP database who had a record of DM diagnosis (E10 - E16 based on ICD 10) or who had any antidiabetic therapy prescribed (ATC group A10) in the periods of 2002-2006 and 2010-2014. A cohort of patients was extracted for analysis, who had an agent from A10 group prescribed at least once in a relevant year (n = 308 962 in 2002; n = 426 695 in 2014). A number of patients was evaluated for each year, who had at least once MET or SU prescribed. The number of patients treated with MET or SU was then expressed as a percentage of all who had any therapy from A10 group prescribed in the year in question.

Results:
Metformin prescriptions have linearly risen from 43% to 77%, while sulfonylurea prescriptions have linearly decreased from 65% to 37%.

Conclusion:
The analysis presents the first evaluation of the development of metformin prescriptions conducted in the Czech Republic and evaluation of its concordance with the recommended procedures for the treatment of DM. The amount of metformin prescribed in the Czech Republic increased from 43% to 77% while the amount of SU prescribed decreased from 65% to 37% between 2002 and 2014. This development and the current ratio between the prescribed amounts of MET and SU demonstrate the implementation of the recommended procedures into practice and prove the high quality of care for patients with DM2T in specialists - diabetologists' surgeries.

Keywords: type 2 diabetes mellitus; metformin; sulfonylurea

Received: October 2, 2015; Accepted: October 18, 2015; Published: June 1, 2015  Show citation