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Trends in the Dispensing and Costs of Glucose-Lowering Medications Among Older Australians: Findings from National Claims Data

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Abstract

Background

Temporal changes in the dispensing of glucose-lowering drugs (GLD) and their associated costs among elderly populations is unclear. This information is especially relevant to countries in which medications are partly or fully government subsidized.

Objective

Our objective was to estimate the trends in prevalence, incidence and costs associated with GLD dispensed to older Australians.

Methods

We analysed Pharmaceutical Benefits Scheme data for 76,906 people aged ≥ 65 years dispensed diabetes medications over the period 2013–2016.

Results

Older males were dispensed more GLD than were older females, with the marginal difference increasing from 3.2% in 2013 (age-sex adjusted incidence rate ratio [aIRR] 1.032; 95% confidence interval [CI] 1.024–1.041; p < 0.001) to 3.9% in 2016 (aIRR 1.039; 95% CI 1.030–1.047; p < 0.001). The number of GLD dispensed per person was consistently lower in those aged ≥ 75 years than in those aged 65–74 years, with the gap widening over the years. More patients were initiated with sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors over the study period, at the expense of older GLD. The proportion of users and attributed costs associated with the use of metformin, sulfonylureas, α-glucosidase inhibitors and thiazolidinediones decreased over time. The total subsidized costs of GLD is forecast to increase to $A395 million by 2020.

Conclusions

The treatment landscape for diabetes in Australia is undergoing dynamic change. More patients were initiated with the newer but costlier GLD over the study period.

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Acknowledgements

The authors acknowledge the Australian Government Department of Human Services for provision of the data.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Ken Lee Chin, Frisky Maulida Hidayat, Richard Ofori-Asenso, Jenni Ilomäki, J. Simon Bell, Sophia Zoungas & Danny Liew

  2. Melbourne Medical School, The University of Melbourne, Level 7, North Wing Medical Building, Parkville, VIC, 3010, Australia

    Ken Lee Chin

  3. Copenhagen Centre for Regulatory Science (CORS), Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Richard Ofori-Asenso

  4. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia

    Jenni Ilomäki & J. Simon Bell

Authors
  1. Ken Lee Chin
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  2. Frisky Maulida Hidayat
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  4. Jenni Ilomäki
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  5. J. Simon Bell
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  6. Sophia Zoungas
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  7. Danny Liew
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Contributions

KLC initially conceived the concept of this study. KLC and ROA were responsible for data collection. KLC and FMH performed the statistical analysis. KLC drafted the manuscript. All the authors made substantial contribution to the interpretation of data and revised the manuscript for important intellectual content. KLC and DL are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Ken Lee Chin.

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Funding

No sources of funding were used to conduct this study or prepare this manuscript.

Conflicts of interest

DL has received research grants and honoraria from AstraZeneca and Boehringer Ingelheim. SZ has previously participated in educational events and advisory boards on behalf of Monash University for AstraZeneca, Merck Sharp & Dohme (Australia), Servier Australia and Novo Nordisk and holds NHMRC Senior Research Fellowships. KLC, FMH, ROA, JI and JSB have no conflicts of interest that are directly relevant to the content of this article.

Ethics statement

This study was approved by the Monash University Human Research Ethics Committee (MUHREC). The Australian Government Department of Human Services also approved the research plan and the final manuscript.

Data availability

The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

Electronic supplementary material

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Supplementary material 1 (DOCX 881 kb)

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Chin, K.L., Hidayat, F.M., Ofori-Asenso, R. et al. Trends in the Dispensing and Costs of Glucose-Lowering Medications Among Older Australians: Findings from National Claims Data. Drugs Aging 37, 393–398 (2020). https://doi.org/10.1007/s40266-020-00759-w

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  • DOI: https://doi.org/10.1007/s40266-020-00759-w

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