Time trends and regional variation in utilization of antidiabetic medicines in China, 2015-2022

Diabetes Obes Metab. 2024 Jul;26(7):2752-2760. doi: 10.1111/dom.15594. Epub 2024 Apr 15.

Abstract

Aim: To assess the use of non-insulin antidiabetic medicines in China.

Materials and methods: We analysed the national procurement data for 29 non-insulin antidiabetic medicines from nine subgroups in China from 2015 to 2022. We estimated the number of defined daily doses (DDDs) procured per year in seven regions of China for nine subgroups and adjusted the data by the number of patients with diabetes. For each subgroup, the regional ratio was calculated by comparing the procurement per patient in each region with the procurement nationwide. The regional disparity was the difference between the highest and lowest regional ratios. We compared the medication patterns across regions.

Results: Nationally, between 2015 and 2022, the number of DDDs per patient increased from 14.45 to 47.37. The two most commonly used categories were sulphonylurea and biguanides, which increased from 7.04 to 15.39 (119%) and 3.28 to 11.11 (239%) DDDs per patient, respectively. The procurement of new drugs (dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter type 2 inhibitors and glucagon-like peptide-1 receptor agonists) increased quickly and had >5000% relative changes. Particularly for sodium-glucose cotransporter type 2 inhibitors, it increased from 0.08 to 5.03 DDDs (6662%). The southwest region had the highest relative change (319%), while the southern region had the lowest (118%). Biguanide and thiazolidinediones had the lowest (1.19) and highest level (2.21) of regional disparity in 2022, respectively.

Conclusion: The procurement of non-insulin antidiabetic medicines in China has increased a lot from 2015 to 2022. In terms of DDDs per patient, sulphonylurea ranked first, followed by metformin. The procurement of new drugs increased greatly. A large regional disparity existed in medicine usage and patterns.

Keywords: China; antidiabetic medicines; prescribing pattern; regional variation; time trends.

MeSH terms

  • Biguanides / therapeutic use
  • China
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus, Type 2* / drug therapy
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use
  • Drug Utilization / statistics & numerical data
  • Drug Utilization / trends
  • Humans
  • Hypoglycemic Agents* / therapeutic use
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use
  • Sulfonylurea Compounds / therapeutic use

Substances

  • Hypoglycemic Agents
  • Biguanides
  • Dipeptidyl-Peptidase IV Inhibitors
  • Sulfonylurea Compounds
  • Sodium-Glucose Transporter 2 Inhibitors