title: Trends in the management of type 2 diabetes and its prescription drug costs in Greece (1998 & 2006).
abstract: AIMS Aim of the present study is to compare control of hyperglycaemia and other diabetes-related cardiovascular risk factors during the years 1998 and 2006 and to estimate the change in the cost of medications prescribed for this purpose. METHODS We compared the medical records of all patients who were regularly followed in three major diabetes centers located in Athens and Piraeus, Greece, during 1998, with those who were examined at the same centers during 2006. The cost of medications was calculated in Euros per patient-year (euroPY), using the 2006 official Greek market prices. RESULTS A total of 1 743 eligible files were included in the study (805 files from 1998 and 938 from 2006). HbA (1c), LDL-cholesterol and blood pressure improved significantly in 2006 as compared to 1998 (7.0% vs. 8.1%, 2.9 mmol/l vs. 3.9 mmol/l and 134.9/77.6 mmHg vs. 139.3/80.9 mmHg respectively, p<0.001 for all comparisons). Treatment of hyperglycaemia was more intense and had a different pattern in 2006. The proportion of patients receiving antihypertensive, hypolipidaemic and antiplatelet drugs increased from 48.8% to 74.4%, from 15.2% to 61.2% and from 17.6% to 51.1% respectively (p<0.001 for all comparisons). A highly significant increase in the cost per patient-year was observed for all classes of medications in 2006. The total cost of all diabetes-related medications increased in 2006 by 221.1% (from 341.3+/-276.0 euroPY to 1095.8+/-634.1 euroPY). CONCLUSIONS Control of cardiovascular risk factors of patients with T2D, regularly followed by diabetes specialists, improved significantly in 2006 as compared to 1998. This improvement, however, was associated with a considerable increase in the cost of medications prescribed for treatment of these parameters.
authors.affiliation: First Department of Internal Medicine, Athens University Medical School and Diabetes Center, Laiko Hospital, 17 Ag. Thoma, 11527 Athens, Greece. s.liatis@yahoo.com
authors.forename: S
authors.initials: S
authors.lastname: Liatis
authors.forename: P
authors.initials: P
authors.lastname: Thomakos
authors.forename: S
authors.initials: S
authors.lastname: Papaoikonomou
authors.forename: A
authors.initials: A
authors.lastname: Papazafeiropoulou
authors.forename: N
authors.initials: N
authors.lastname: Giannakopoulos
authors.forename: E
authors.initials: E
authors.lastname: Karagiaouri
authors.forename: A
authors.initials: A
authors.lastname: Sotiropoulos
authors.forename: S
authors.initials: S
authors.lastname: Bousboulas
authors.forename: A
authors.initials: A
authors.lastname: Melidonis
authors.forename: S
authors.initials: S
authors.lastname: Pappas
authors.forename: N
authors.initials: N
authors.lastname: Katsilambros
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000191:economics*; D004035:Diet Therapy / Q000191:economics*; D019468:Disease Management; D016527:Drug Costs / Q000639:trends; D004363:Drug Utilization / Q000639:trends*; D005260:Female; D006115:Greece; D017048:Health Care Costs / Q000639:trends; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D055553:Prescription Drugs / Q000191:economics*; D055656:Prescriptions / Q000191:economics; D012307:Risk Factors
chemical_list: D055553:Prescription Drugs