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Exp Clin Endocrinol Diabetes 2022; 130(09): 587-595
DOI: 10.1055/a-1702-5151
Article

Dispensation Patterns of Glucose-Lowering Drugs in Newly Diagnosed Type 2 Diabetes: Routine Data Analysis of Insurance Claims in Germany

Brenda Bongaerts
1   Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
2   German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
,
Bianca Kollhorst
3   Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
,
Oliver Kuss
1   Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
2   German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
,
Iris Pigeot
3   Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
4   University of Bremen, Faculty of Mathematics and Computer Science, Bremen, Germany
,
Wolfgang Rathmann
1   Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
2   German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
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Abstract

Aims To describe dispensation patterns of glucose-lowering drugs in newly diagnosed type 2 diabetes in Germany.

Materials and methods Based on claims data from four statutory health insurances (German Pharmacoepidemiological Research Database,>25 million insurants), all individuals with newly diagnosed type 2 diabetes were identified. Eligible patients had a first diagnosis for type 2 diabetes between January 2012 and December 2016. We analyzed the dispensation patterns of first-line glucose-lowering therapies initiated in the year after diabetes diagnosis and patterns of second-line therapies dispensed one year after first-line treatment.

Results A total of 356,647 individuals with newly diagnosed type 2 diabetes were included (average age [SD]: 63.5 [13.4] years; 49.3% males). Of the 31.6% of individuals who were pharmacologically treated in the year after diagnosis, metformin monotherapy was most frequently dispensed (73.1%), followed by dual therapy of metformin and dipeptidyl peptidase-4 inhibitors (DPP-4is) (6.4%), and monotherapy with DPP-4is (2.9%). From 2012 through 2016, sulfonylurea dispensations were reduced by more than 50%. Dispensations for combination therapies with DPP-4is increased up to 10.6%. Glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors contributed to 2% of all treatments. After a median of 5 months, 20.0% of individuals on pharmacological therapy initiated second-line glucose-lowering treatment.

Conclusions Data from German statutory health insurances (2012 to 2016) showed that most individuals with newly diagnosed type 2 diabetes were dispensed metformin monotherapy in line with diabetes care guidelines. A substantial decrease in the use of sulfonylureas was observed after the introduction of DPP-4i and GLP-1 receptor agonists.

Key words

Administrative data - drug dispensation patterns - Germany - glucose-lowering treatment - health insurance claims data - type 2 diabetes


Publikationsverlauf

Eingereicht: 21. Juni 2021

Angenommen: 16. November 2021

Artikel online veröffentlicht:
23. Dezember 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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