Drug prescription patterns and cost analysis of diabetes therapy in India: Audit of an endocrine practice

Abstract

Aims: The aim of this study was to analyze the current trend in the use of antidiabetes as well as other drugs for comorbidities along the duration of diabetes. The study also aimed to analyze the direct drug cost to patients. Settings and Design: Retrospective cross-sectional study. Subjects and Methods: Data captured in clinic electronic medical records of an endocrine practice was analyzed. Statistical Analysis Used: Data was analyzed descriptively using machine learning codes on python platform. Results: Records of 489 people who attended the clinic during the 6-month period were retrieved. Data of 403 people with diabetes were analyzed after exclusion of incomplete data. Use of antidiabetic drug increased from 1.44 (0.78) [mean (standard deviation)] in people with a duration of diabetes <5 years to 3.18 (1.05) in people with 20+ years of diabetes. The mean number of antidiabetic drug usage seems to plateau at 15 years of diabetes. About 46% of people with 20+ years of diabetes required insulin therapy. Prescription patterns involving a combination of different drug classes in patients were also analyzed. The cost of diabetes therapy increases linearly along the duration of diabetes. Conclusion: This study provides valuable insights on temporal prescription patterns of antidiabetic drugs from an endocrine practice. Metformin remains the most preferred drug across the entire duration of diabetes. Dipeptidyl peptidase-4 inhibitors seem to be fast catching up with sulfonylureas as a second-line treatment after metformin. After 20 years or more of diabetes duration, 46% people would require insulin for glycemic control.

Pattern of Disease and Therapy for Diabetes along with Impact of Generic Prescribing on Cost of Treatment among Outpatients at a Tertiary Care Facility

“…The mean age of the persons with diabetes was around 54 years with majority of individuals in the 40–65 age groups, which is comparable to earlier similar studies in different parts of India [ 13 14 , 16 17 ] and significantly lower ( P < 0.0000001) than a study conducted in the northeastern state of Sikkim. [ 15 ] This age is also significantly lower than that seen in the U.S. and other countries [ 18 19 20 ] indicating an earlier age of onset of T2DM in our setting.…”

“…[ 7 ] The mean duration of diagnosed diabetes was more than 8 years, which is statistically similar to earlier reported data. [ 14 15 ] Patients are likely to come to a tertiary care center later in their diabetes progression; almost half the patients had a duration of diabetes of >5 years which is a significantly higher proportion compared to a recently published from a private center in New Delhi, [ 13 ] and one fourth had duration >10 years.…”

Vitamin B12 deficiency is endemic in Indian population: A perspective from North India

“…[16] We reported previously that 44% of people with diabetes were prescribed vitamin supplements during their routine diabetes care. [19] Secondly, people without diabetes might seek attention later due to long latent period of manifestations of vitamin B12 deficiency. Our effort to document exogenous supplementation was not successful due to non-centralized nature of healthcare system in India and over-the-counter availability of vitamin B12 preparations.…”

The Position of Gliclazide in the Evolving Landscapes and Disease Continuum of T2DM: A Collaborative Delphi Survey-Based Consensus from India

“…Sulfonylureas (SUs) are widely used in India because of their glucose-lowering efficacy and affordability, with glimepiride and gliclazide being the most commonly prescribed SUs. A retrospective cross-sectional study from India found an increase in the use of SUs from 23.12% in patients with diabetes for 0–5 years to 70.77% in patients with diabetes for 10–15 years [ 3 ].…”