Vnitr Lek 2025, 71(8):509-515

Unrealized potential of innovative therapies for type 2 diabetes - the economic burden of preventable cardiorenal complications

Tomáš Doležal¹, Klára Lamblová¹, Kateřina Chadimová¹, Barbora Decker¹, Bohdana Kubešová², Iva Piljarová³, Klára Koubková⁴, Michal Kostern⁵, Anastasie Halas¹

¹ Institut pro zdravotní ekonomiku a technology assessment (iHETA)

² Sanofi s.r.o., Praha

³ NovoNordisk s.r.o., Praha

⁴ Boehringer Ingelheim spol. s r.o., Praha

⁵ AstraZeneca Czech Republic s.r.o., Praha

In the Czech Republic, the prevalence of type 2 diabetes is significantly increasing. For the future sustainability of treatment costs related to complications, timely treatment based on evidence-based medicine and in accordance with clinical guidelines is essential. The current consensus on type 2 diabetes treatment focuses not only on glycemic and weight control but primarily on reducing cardiorenal risk using modern drug classes with sufficient evidence - GLP-1 receptor agonists and SGLT2 inhibitors. An analysis of administrative patient data from 81,204 insured individuals of the health insurance companies OZP, RBP, and ZPS, who had the E11 (type 2 diabetes) diagnosis recorded at least twice between 2019-2023 and are undergoing antidiabetic pharmacotherapy, revealed very low penetration of these drug classes among patients who, according to guidelines, should be receiving them. A full 85 % of diabetic patients with ASCVD are without optimal treatment, as are 76 % of patients with heart failure and 74 % of patients diagnosed with CKD. The health insurance system thus loses CZK 412 million annually due to atherosclerotic complications, CZK 211 million/year due to heart failure, and CZK 270 million/year due to suboptimal pharmacotherapy in chronic kidney disease.

Keywords: type 2 diabetes, suboptimal pharmacotherapy, payer administrative data, organ complications.

Accepted: November 26, 2025; Published: December 15, 2025  Show citation