Incretins and SGLT-2i Therapy of Type 2 Diabetes – Real Life Study of Their Therapeutic and Economic Effects

Frontiers in Pharmacology

Zhivko Angelov¹  Dimitar Tcharaktchiev²  Manoela Manova³  Vasil Valov³  Alexandra Savova³  Maria Kamusheva³  Guenka Petrova³  Zornitsa Mitkova³  Konstantin Mitov³  Galia Angelova⁴ 

[1] Adiss Lab Ltd., Sofia, Bulgaria;Department of Endocrinology, University Specialized Hospital for Active Treatment of Endocrinology, Sofia, Bulgaria;Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria;Institute of Information and Communication Technologies, Bulgarian Academy of Sciences, Sofia, Bulgaria;

关键词: incretins;    SGLT-inhibitors;    diabetic incidents;    HbA1c level;    cost study;   

DOI  :  10.3389/fphar.2019.00364

来源: DOAJ

【 摘 要 】

AimIncretins [dipeptidyl peptidase-4 inhibitors (DPP-4i) and glucagon-like peptide 1 RA (GLP-1 RA)] and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) groups are now routinely used for type 2 diabetes therapy and comprise a large number of medicinal products. The long term therapeutic and economic effect of the incretins’ and SGLT-2i in real life setting is not well documented. The goal of the current study is to analyze the cost and results of incretins and SGLT-2i based therapy for type 2 diabetes in Bulgaria.MethodsThe study uses information about the changes in glycated hemoglobin (HbA1c) level from the National diabetes register for 6122 patients and cost paid by the National Health Insurance Fund (NHIF) for diabetes complications, and medicine prices.ResultsThe results show that after the therapy patients achieved excellent diabetes control. There were no HbA1c values less than 6% before treatment. After the therapy, 3356 people showed values less than 7% HbA1c. It is considered very good diabetic control. The number of people with HbA1c above 8% is decreasing significantly. The number of people with values above 9% is decreasing by almost four times. HbA1c level decreases with the highest percentage for the patients treated with GLP-1 RA, followed by those treated with DPP-4i and SGLT-2i. For a year NHIF reimbursed 5.25 million BGN for incretins and SGLT-2i therapy. NHIF can save between 306 and 510 thousand BGN from incidents that have not occurred as a result of 5 years of therapy.ConclusionIncretins [dipeptidyl peptidase-4 inhibitors (DPP-4i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA)] and sodium-glucose linked transporter-2 inhibitors (SGLT-2i) therapy steadily decreases the HbA1c level, and risk of developing diabetic incidents is reduced to between 333 and 465 cases among 6122 treated patients. Avoided cost for therapy of diabetes incidents account for between 305 and 510 thousand BGN.

【 授权许可】

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