Trends in the prescription of antidiabetic medications in France: evidence from primary care physicians

Abstract

This study examined prescribing patterns for antidiabetic medications in France and explored the relationships between those patterns and changes in patient characteristics. Data were obtained from the IMS Disease Analyzer-Mediplus France Database (IMS Health Incorporated, London, United Kingdom). Patients were included in the study if they were identified as having type 2 diabetes during the calendar years 2001 to 2003. Univariate analyses examined changes in patient characteristics and trends in prescribing over time. In addition, multivariate logistic regression analysis examined the impact of the year on the likelihood of a patient's receiving prescriptions for a specific therapy. A total of 14,281 unique diabetic patients were studied during the years 2001 through 2003. An average of 1.28 drug therapy episodes per calendar year was reported among individual users of antidiabetic agents. Univariate analysis revealed that between 2001 and 2003, monotherapy with sulfonylurea decreased from 34.98% to 29.47% (P<.0001), monotherapy with metformin increased from 17.38% to 21.31% (P<.0001), and monotherapy with insulin increased from 1.71% to 2.27% of the population (P=.0437). Multivariate logistic regression analyses that compared prescription therapy episodes in 2003 with those in 2001 revealed that the influence of the year on the likelihood of metformin or insulin use (alone or in combination with other medications) was positive and significant (P<.05). In contrast, the influence of the year on the likelihood of sulfonylurea monotherapy use was negative and significant (P<.05). In France, antidiabetic medication prescribing patterns changed from 2001 to 2003. In general, the trend has been away from sulfonylurea monotherapy and toward metformin monotherapy, insulin monotherapy, or combination therapy.