Trends in antidiabetic drug utilization and expenditure in Denmark: A 22‐year nationwide study

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2020-02, Vol.22 (2), p.167-172
• Main Authors: Bang, Camilla, Mortensen, Martin B., Lauridsen, Kasper G., Bruun, Jens M.
• Format: Article
• Language: English
• Subjects: antidiabetic drug; Antidiabetics; cost‐effectiveness; database research; Denmark - epidemiology; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - economics; Diabetes Mellitus, Type 2 - epidemiology; Dipeptidyl-peptidase IV; Drug Costs - trends; Epidemiology; Expenditures; GLP-1 receptor agonists; Glucagon; Glucose transporter; health economics; Health Expenditures - trends; History, 20th Century; History, 21st Century; Humans; Hypoglycemic Agents - classification; Hypoglycemic Agents - economics; Hypoglycemic Agents - therapeutic use; Incidence; Insulin; Patient Acceptance of Health Care - statistics & numerical data; Peptidase; pharmaco‐economics; pharmaco‐epidemiology; Practice Patterns, Physicians' - economics; Practice Patterns, Physicians' - history; Practice Patterns, Physicians' - statistics & numerical data; Practice Patterns, Physicians' - trends; Sodium; Trends
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.13877

Aims To examine the nationwide trends in antidiabetic drug utilization and expenditure in Denmark over the past 22 years. Methods Data on antidiabetic use and expenditure from 1996 to 2017 were retrieved from the Register of Medicinal Product Statistics. Antidiabetic drug use is reported as defined daily dose (DDD) in total counts and per 1000 inhabitants/d. Expenditure is reported as volume sold in total counts per 1000 inhabitants and as annual mean expenditure. Results Throughout the study period, the total use of antidiabetic drugs increased from 16.4 to 55.8 DDDs per 1000 inhabitants/d, while total expenditure increased from €59 to €286 m. The introduction of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs), dipeptidyl peptidase‐4 inhibitors and sodium‐glucose co‐transporter‐2 inhibitors has, since 2005, led to considerable variation in the proportional use of the different drug classes. Use of insulin and insulin analogues accounted for the majority of the cost of antidiabetic drugs, peaking at 75% in 2008; however, its proportional impact on overall antidiabetic drug expenditure decreased to ~44% in 2017. In contrast, a steep increase in GLP‐1RA expenditure was observed from 2010 to 2017, reaching an annual cost of €85 m (~29% of all antidiabetic expenditure). Conclusion Antidiabetic drug utilization and cost in Denmark has increased considerably over the last 22 years, in accordance with the increased incidence of type 2 diabetes and changes in treatment guidelines. The release of several novel antidiabetic drugs seems to be responsible for the increase in antidiabetic drug expenditure.