CONSUMPTION ANALYSIS OF METFORMIN, SULFONYLUREAS, AND OTHER ANTIDIABETICS DRUGS IN MOROCCO (1991-2005)
Keywords:
Defined Daily Dose, Consumption, Metformin, Sulfonylureas, AntidiabeticAbstract
Objective: Type 2 Diabetes is one of the chronic diseases with a high prevalence and consequently a substantial socio-economic burden in Arab countries. In this paper, we evaluated the antidiabetic drugs consumption in Morocco during the period of 1991 to 2005, drug classes used and the effect of major studies on the consumption of the biguanides.
Methods: We used sales data from the subsidiaries of the Intercontinental Marketing Service Health. The consumption volume was converted to Defined Daily Dose (DDD).
Results: During 1991-2005 antidiabetic drugs consumption increased from 1.37 to 4.22 DDD/1000 inhabitants/day. In 2005 the sulfonylureas were the most consumed 2.96 DDD/1000 inhabitants/day) followed by the Biguanides (1.06 DDD/1000 inhabitants/day) and glinides 0.1 DDD/1000inhabitants/day. The largest consumption share in volume was held by sulfonylureas 72.22%, followed by the biguanides 22.22%.
Conclusion: This study documents progressive changes in the consumption of antidiabetic's between 1991-2005 in Morocco. However, the significant increase in the utilization of antidiabetic's drugs is not the result of increased adherence but of increased patient number, since the use of metformin as first line therapy was still suboptimal and influenced by different studies as the Campbell and UKPDS study.Â
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References
Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;414:782-7.
Roglic G, Unwin N, Bennett PH, Mathers C, Tuomilehto J, Nag S, et al. The burden of mortality attributable to diabetes realistic estimates for the year. Diabetes Care 2005;28:2130-5.
Asghari S, Courteau J, Carpentier AC, Vanasse A. Optimal strategy to identify incidence of diagnostic of diabetes using administrative data. BMC Med Res Methodol 2009;9:62.
Arteagoitia JM, Larranaga MI, Rodriguez JL, Fernandez I, Pinies JA. Incidence, prevalence and coronary heart disease risk level in known type 2 diabetes: a sentinel practice network study in the Basque country, Spain. Diabetologia 2003;46:899-909.
UK Prospective Diabetes Study (UKPDS) Group Intensive blood–glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53.
Lau DT, Nau DP. Oral antihyperglycemic medication nonadherence and subsequent hospitalization among individuals with type 2 diabetes. Diabetes Care 2004;27:2149-53.
Schectman JM, Nadkarni MM, Voss JD. The association between diabetes metabolic control and drug adherence in an indigent population. Diabetes Care 2002;25:1015-21.
Cramer JA. A systemic review of adherence with medication for diabetes. Diabetes Care 2004;27:1218-24.
Tazi MA, Abir-Khalil S, Chaouki N, Cherqaoui S, Lahmouz F, Sraïri JE, et al. Prevalence of the main cardiovascular risk factors in morocco: results of a national survey, 2000. J Hypertens 2003;21:897-903.
Berrada El Azizi G, Ahid S, Ghanname I, Belaiche A, Hassar M, Cherrah Y. Trends in antihypertensives use among Moroccan patients. Pharmacoepidemiol Drug Saf 2012;21:1067-73.
World Health Organization. WHO collaborating centre for drug statistics methodology: ATC classification index with DDDs and Guidelines for ATC classification and DDD assignment. Oslo, Norway: Norwegian Institute of Public Health; 2006. p. 15.
Viens G, Levesque K, Chahwakilian P, El Hasnaoui A, Gaudillat A, Nicol G, et al. Évolution comparée de la consommation de médicaments dans 5 pays européens entre 2000 et 2004: analyse de 7 classes pharmaco-thérapeutiques. ESSEC; 2007. p. 21.
Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393.
Howlett HC, Bailey CJ. A risk-benefit assessment of metformin in type 2 diabetes mellitus. Drug saf 1999;20:489-503.
Cohen FJ, Conklin JE, Neslusan CA, Song X. Recent antihyperglycemic prescribing trends for U. S. privately insured patients with type 2 diabetes. Diabetes Care 2003;26:1847-51.
Walley T, Hughes D, Kendall H. Trends and influences on use of antidiabetic drugs in England, 1992–2003. Pharmacoepidemiol Drug Saf 2005;14:769-73.
Turner RC, Cull CA, Frighi V, Holman RR. UK prospective diabetes study (UKPDS) Group. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). JAMA 1999;281:2005-12.