Prescription Pattern and Costs of Antidiabetic Medications in Patients With Type 2 Diabetes by Specialist Physicians and Non-specialist Physicians
Author(s)
Manato Yoshida, Akinori Oh, PhD, Ryosuke Kumazawa, PhD, Manabu Akazawa, MPH, PhD.
Meiji Pharmaceutical University, Kiyose, Japan.
Meiji Pharmaceutical University, Kiyose, Japan.
Presentation Documents
OBJECTIVES: In Japan, ten types of medications are available for the treatment of type 2 diabetes mellitus (T2DM). While national guidelines recommend biguanides (BG) as the first-line therapy, previous studies have reported that dipeptidyl peptidase-4 inhibitors (DPP-4i) are most frequently prescribed. This study aimed to investigate the real-world treatment patterns of newly treated T2DM patients, stratified by whether diabetes specialists or non-specialists prescribed, using claims data.
METHODS: We used claims data from DeSC Healthcare Inc. The study included patients aged 18 years or older with a diagnosis of T2DM (ICD-10 codes: E11, E14), who received their first prescription of a T2DM medication between November 2014 and August 2022. A 6-month washout period ensured patients were newly treated. Patients who visited a facility with a history of insulin prescriptions were categorized as the diabetes specialist group; others were categorized as the non-specialist group. The first T2DM medication prescribed was defined as the first-line therapy. We descriptively summarized the types of first-line drugs and their 12-month treatment continuation rates.
RESULTS: In specialist group (274,607 patients), the most commonly prescribed first-line therapies were DPP-4i (38.9%), insulin (19.4%), and combination therapy (16.7%). In contrast, in the non-specialist group (18,668 patients) DPP-4i (50.1%), sodium-glucose cotransporter 2 inhibitors (SGLT-2i) (13.6%), and combination therapy (13.4%) were most common. The 12-month continuation rate for DPP-4i, the most frequently prescribed drug in both groups, was 76.1% in the specialist group and 75.5% in the non-specialist group showing no significant difference.
CONCLUSIONS: Despite guideline recommendations, more costly drugs such as DPP-4i (94.5 yen / day) and SGLT-2i (160.7 yen / day) were prescribed more often than BG (20.5 yen / day). Possible reasons include lower risk of hypoglycemia, additional benefits, and lower dosing frequency. However, considering cost-effectiveness, the current treatment practices, which show low adherence to guidelines, may require improvement.
METHODS: We used claims data from DeSC Healthcare Inc. The study included patients aged 18 years or older with a diagnosis of T2DM (ICD-10 codes: E11, E14), who received their first prescription of a T2DM medication between November 2014 and August 2022. A 6-month washout period ensured patients were newly treated. Patients who visited a facility with a history of insulin prescriptions were categorized as the diabetes specialist group; others were categorized as the non-specialist group. The first T2DM medication prescribed was defined as the first-line therapy. We descriptively summarized the types of first-line drugs and their 12-month treatment continuation rates.
RESULTS: In specialist group (274,607 patients), the most commonly prescribed first-line therapies were DPP-4i (38.9%), insulin (19.4%), and combination therapy (16.7%). In contrast, in the non-specialist group (18,668 patients) DPP-4i (50.1%), sodium-glucose cotransporter 2 inhibitors (SGLT-2i) (13.6%), and combination therapy (13.4%) were most common. The 12-month continuation rate for DPP-4i, the most frequently prescribed drug in both groups, was 76.1% in the specialist group and 75.5% in the non-specialist group showing no significant difference.
CONCLUSIONS: Despite guideline recommendations, more costly drugs such as DPP-4i (94.5 yen / day) and SGLT-2i (160.7 yen / day) were prescribed more often than BG (20.5 yen / day). Possible reasons include lower risk of hypoglycemia, additional benefits, and lower dosing frequency. However, considering cost-effectiveness, the current treatment practices, which show low adherence to guidelines, may require improvement.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD38
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)