Glatz, P

Hrmova, D

Ilavska, A

Koren, B

Tesar, T

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PDB51 DRUG USE FOR DIABETES MELLITUSTYPE 2 AND ITS COMPLICATIONS IN SLOVAKIA 

prescription habits. Our study conﬁrmed the difference in pre-
scription habits and results should be disclosed to prescribers.
Mutual co-operation of health insurance and specialists on
similar analyses and quality indexes speciﬁcations has a great
potential to change the treatment patterns and could lead
to signiﬁcant savings when followed by direct feedback and
education.
DIABETES—Health Care Use & Policy Studies
PDB51
DRUG USE FOR DIABETES MELLITUSTYPE 2 AND ITS
COMPLICATIONS IN SLOVAKIA
Ilavska A1, Koren B2, Hrmova D3,Tesar T4, Glatz P5
1Railway Hospital, Bratislava, Slovak Republic, 2Health Insurance Fund
Apollo, Bratislava, Slovak Republic, 3GSK, Bratislava, Slovak Republic,
4Comenius University, Bratislava, Slovak Republic, 5Janssen-Cilag,
Bratislava, Slovak Republic
OBJECTIVES: Diagnosis of diabetes mellitus is the 4th in drug
spending in Slovakia. Our objective was to explore drug costs for
diabetes and pharmacotherapy break down costs on antidiabet-
ics as well as the complications or co-morbidities prevalence and
treatment. Drug consumption was compared for diabetic and
non-diabetic patients. METHODS: We used claims data of reim-
bursed medicines in the y.2005 of one private health insurance
fund. Diabetic patient was identiﬁed as the one with at least two
prescriptions regarding DM diagnosis on annual basis. We com-
pared prescription on the ATC3 level in costs and also in DDDs
for diabetic and non-diabetic patients regarding the age group
(analysis done for each age decade). RESULTS: We identiﬁed
13.481 diabetics /DM/ representing 7% of total diabetic patients
undergoing pharmacotherapy in Slovakia. All other policyhold-
ers with prescriptions were included into the control group /non-
DM/. The highest number of diabetic patients belongs to the age
group of 50–59. Average annual drug cost per patient was: 655
EUR for DM versus 127 EUR for non-DM, what represents
about 355% higher costs for DM. In drug costs of DM2 treat-
ment antidiabetics represent 33% and other pharmacotherapy
stands for 67%. Three leading ATC3 in reimbursed costs per
diabetic patient were: C10A, C09A and A16A. The main differ-
ences in drug use prevalence except antidiabetics occur in the
following drug groups: C09A ACE plain inhibitors (50% of DM
versus 10% of non-DM with prescription); B01A antithrombot-
ics (46% DM versus 9% non-DM) and C10A cholesterol and
triglyceride reducers (40% DM versus 6% non-DM). CONCLU-
SION: DM diagnosis implies a relevant economic impact. Besides
diabetics, the main cost driver is a cardiovascular treatment. This
analysis will be followed by evaluation of the rationality in the
prescription among diabetologists and could be the base for
other pharmacoeconomic studies.
PDB52
FACTORS ASSOCIATED WITHTHE CHOICE OF A
GLITAZONES OR SULFONYLUREA AS ADD ONTO ONGOING
METFORMIN MONOTHERAPY
Mavros P, Yin D, Krishnarajah G
Merck & Co., Inc,Whitehouse Station, NJ, USA
OBJECTIVES: To assess the differences between patient charac-
teristics of Type 2 diabetic patients that add sulfonylurea (SU) vs.
glitazone(PPAR) to ongoing metformin(MF) to attain adequate
glycemic control in the real life practice settings in UK.
METHODS: Retrospective clinical chart review and patient
survey at the point of visit were conducted among patients aged
°Ý30 year at time of diagnosis of T2 DM and added a SU or
PPAR to MF mono-therapy in UK from Dec 2006 to Jan 2007.
The information of each patient on HbA1c, medication use,
co-morbid conditions was collected for the 7-month baseline
period (on MF monotherpy) and the minimum a year follow-up
period (since the addition of SU or PPAR to MF). RESULTS:
Data from 412 patients (52% initially added SU to MF and 48%
added PPAR) was collected. For the SU+MF and PPAR+MF
groups respectively: mean age on MF alone was 60.8(SD = 11.2)
and 59.6(SD = 11.8) years; age at diagnosis was 56.2(SD = 10.8)
and 54.5(SD = 11.7) years; A1C prior to addition of SU or PPAR
was 8.6(SD = 1.5) and 8.6(SD = 1.4); The following variables
between the SU+MF and PPAR+MF groups respectively showed
signiﬁcant differences between the two groups: Weight 85.8 kg
(SD = 18.9) and 90.1 kg (SD = 19.0); BMI was 30.4 (SD = 6.5)
and 31.8 (SD = 7.0); % with Ischemic Heart Disease was 25.7%
and 16.6%; % with MI was 11.8% and 5%; mean total choles-
terol was 5.09 mmol/L (SD = 1.1) and 4.7 mmol/L (SD = 1.1);
mean LDL was 2.8 mmol/L (SD = 1.0) and 2.5 mmol/L
(SD = 1.1). Adjusted logistic regression showed that a lower total
cholesterol value (OR = 0.71 95%CI = 0.58–0.87) was associ-
ated with PPAR added to MF compared to SU patients. CON-
CLUSION: In this study population half of the patients added
PPAR to ongoing MF monotherapy. Patients adding PPAR to MF
tended to have lower cholesterol levels.
PDB53
AN EVALUATION OFTREATMENT DISCONTINUATION
PATTERNS IN PEOPLE WITHTYPE 1 ANDTYPE 2 DIABETES
SWITCHEDTO ALTERNATIVE SHORT ACTING INSULIN
REGIMENS IN UK GENERAL PRACTICE
Currie CJ1, Poole C2,Tynan A3, Simpson A3
1Cardiff University, Cardiff, UK, 2Pharmatelligence Limited, Cardiff, UK,
3Eli Lilly and Company Limited, Surrey, UK
OBJECTIVES: Treatment discontinuation may occur from a
variety of reasons. The purpose of this study was to characterise
treatment discontinuation in people who used either insulin
lispro, other short acting insulin (SAI) analogues’, or soluble
regular human insulin (RHI). METHODS: Data were extracted
from the GPRD, a resource that describes the primary care
histories of around 7% of the UK population. Subjects were
selected having been treated with one SAI. Cox proportional
hazard models (CPHM) were used to determine relative treat-
ment duration since these data were censored. A variety of cova-
riates were considered. RESULTS: We identiﬁed 7,958 subjects:
31% SAI analogue, 25% lispro and 44% RHI. Of these, 68.2%
had T1DM. In type 1 diabetes (T1DM) the mean age was 36.4
years (sd. 17.6) years with 45% female. In T2DM, the mean age
was 55.8 years (sd. 13.7) with 46% female. Regarding type 1
diabetes; the median treatment duration with a SAI regimen
was 11.6 years. Relative to RHI, the hazard ratio (HR) of dis-
continuation was 24.6% worse using other SAI analogue regi-
ments (p < 0.001), and 25.1% better with lispro (p < 0.001).
Gender—being male—was the only other signiﬁcant factor
(HR = 0.798; p < 0.001). Regarding type 2 diabetes; the median
treatment duration with a SAI regimen was 5.6 years. Relative to
RHI, the hazard ratio (HR) of discontinuation was 21.1% worse
using other SAI analogue regiments (p < 0.008), and 25.7%
better with lispro (p < 0.001). Age at SAI regimen initiation was
the only other signiﬁcant factor in the T2DM discontinuation
model (HR = 1.011; p < 0.001). CONCLUSION: There was a
discernable pattern to treatment discontinuation in people
treated with alternative SAI regimens. Insulin lispro resulted in
less likelihood of switching treatment. Gender was an important
predictor of treatment discontinuation in T1DM and subject age
at initiation in T2DM.
A270 Abstracts


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PDB51 DRUG USE FOR DIABETES MELLITUSTYPE 2 AND ITS COMPLICATIONS IN SLOVAKIA

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