Disparities in Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors prescription and dispensing in the Israeli population – a retrospective cohort study.

Objective: To describe disparities in prescribing and dispensing Sodium-glucose Cotransporter-2 Inhibitors (SGLT2i) in Israel.Research Design and Methods: A population-based retrospective cohort study of adults with type 2 diabetes mellitus eligible for SGLT2i treatment from 2017 to 2023. The primary outcome was time between initial eligibility and first prescription of SGLT2i. Results: Among 32,742 eligible patients, only 53% were prescribed SGLT2i. Multivariable analyses, adjusting for death as competing risk, revealed delays in prescription associated with older age, Arab or Bedouin ethnicity, neoplasms, acute kidney failure, falls, previous hospitalization, urinary tract infections and dementia. Factors associated with shorter time intervals to prescription were gender (men), medium/high socioeconomic status and residing in an intermediate or central area of Israel.Conclusions: Disparities in drug prescription exist even in a country with universal health coverage. Addressing these disparities requires improvements in healthcare systems, education and alert systems to overcome barriers to evidence-based interventions. </p