Adherence to Guidelines for the Treatment of Diabetes With Modern Antidiabetic Drugs in the Czech Republic: Clinical and Economic Impacts
Author(s)
Martina Mazalova, MSc1, Klara Lamblova, MSc1, Tomáš Doležal, PhD, MD1, Ondrej Stuchlik, Ing.1, Jana Adamcakova, PhD.1, Barbora Decker, M.D., Ph.D.2, Katerina Chadimova, MA2, Anastasie Halas, Ing.2.
1Value Outcomes s.r.o., Prague, Czech Republic, 2Institute of Health Economics and Technology Assessment, Prague, Czech Republic.
1Value Outcomes s.r.o., Prague, Czech Republic, 2Institute of Health Economics and Technology Assessment, Prague, Czech Republic.
OBJECTIVES: The Czech Republic has one of the highest prevalence rates of type 2 diabetes mellitus (T2DM) in Europe, with over 1.1 million people affected. The disease imposes a significant burden on the healthcare system due to frequent macro- and microvascular complications. Current clinical guidelines recommend using modern antidiabetic drugs with proven organ-protective effects, such as SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP-1 RA), particularly for high-risk patients. This analysis aimed to evaluate adherence to these recommendations in the Czech Republic and estimate the potential reduction in complications and healthcare costs through the optimal use of these therapies.
METHODS: Administrative data from three health insurance companies, covering 81,204 patients with T2DM who were treated between 2019 and 2023, were analyzed. Adherence to guideline-recommended therapy was assessed by linking ICD-10 diagnoses with prescriptions. Efficacy data on the prevention of complications in patients with ASCVD, HF, and CKD by SGLT2i and GLP-1 RA were obtained from clinical trials. Cost data were sourced from official SÚKL documents. The results were extrapolated to the national T2DM population.
RESULTS: Only 15% of patients with ASCVD and 24% of patients with HF or CKD received the recommended therapy. Overall, 76-85% of high-risk patients do not receive optimal treatment. Full adherence could prevent up to 8,500 ASCVD complications (saving CZK 412 million annually), 3,000 HF complications (saving CZK 211 million annually), and 1,600 CKD complications (saving CZK 270 million annually). The most commonly prevented outcomes include cardiovascular death, hospitalizations, and nephropathy progression.
CONCLUSIONS: Despite strong evidence and reimbursement availability, modern antidiabetic drugs remain underused among high-risk patients with T2DM in the Czech Republic. This underuse contributes to preventable complications and a substantial economic burden. Improving adherence to guideline-recommended therapy represent a key opportunity to improve outcomes and reduce costs.
METHODS: Administrative data from three health insurance companies, covering 81,204 patients with T2DM who were treated between 2019 and 2023, were analyzed. Adherence to guideline-recommended therapy was assessed by linking ICD-10 diagnoses with prescriptions. Efficacy data on the prevention of complications in patients with ASCVD, HF, and CKD by SGLT2i and GLP-1 RA were obtained from clinical trials. Cost data were sourced from official SÚKL documents. The results were extrapolated to the national T2DM population.
RESULTS: Only 15% of patients with ASCVD and 24% of patients with HF or CKD received the recommended therapy. Overall, 76-85% of high-risk patients do not receive optimal treatment. Full adherence could prevent up to 8,500 ASCVD complications (saving CZK 412 million annually), 3,000 HF complications (saving CZK 211 million annually), and 1,600 CKD complications (saving CZK 270 million annually). The most commonly prevented outcomes include cardiovascular death, hospitalizations, and nephropathy progression.
CONCLUSIONS: Despite strong evidence and reimbursement availability, modern antidiabetic drugs remain underused among high-risk patients with T2DM in the Czech Republic. This underuse contributes to preventable complications and a substantial economic burden. Improving adherence to guideline-recommended therapy represent a key opportunity to improve outcomes and reduce costs.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE40
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)