Medicines for the treatment of diabetes
Page last updated: 30 June 2017
Drug utilisation sub-committee (DUSC)
February 2017
Abstract
Purpose
To review the utilisation of medicines for the treatment of diabetes.
Background
There have been a number of new medicines and extensions to PBS listings since the last DUSC review in February 2013.
Key changes have included the listing of sodium-glucose co-transporter 2 inhibitors (flozins), extensions to listings for the dipeptidyl peptidase‑4 inhibitors (gliptins) and the glucagon-like peptide-1 (GLP-1) analogue, and the availability of additional fixed dose combination products. Further details are provided in Table 1 of this report.
Current PBS restrictions (abridged)
Metformin, sulfonylureas, acarbose and most insulins have unrestricted PBS listings. Insulin detemir has a restricted benefit listing for type 1 diabetes.
The gliptins, flozins, exenatide (GLP-1 analogue) and pioglitazone have Authority Required (STREAMLINED) listings for patients meeting certain criteria and for use in combination with specified medicines.
Rosiglitazone has an Authority Required (telephone) listing for patients meeting certain criteria and in combination with other specified medicines.
For further details see Table 2 of this report or pbs.gov.au
Data Source / methodology
Data were extracted from the Department of Human Services (DHS) prescription database for prescriptions supplied from July 2011 to September 2016. Drug regimens were estimated on a weekly basis.
Key Findings
- In mid-2016, 3.85%[1] of the Australian population (928,561 people) were estimated to be receiving diabetes medicines, compared with 3.57%[2] (811,009 people) in mid-2012.
- At the end of July 2016, about half of all people receiving medicines for diabetes were estimated to be on monotherapy and half were on two or more medicines.
- The top five most common regimens (starting with the most common) were metformin monotherapy, insulin monotherapy, gliptin + metformin, metformin + sulfonylurea and insulin + metformin (See Figure 3).
- The regimens that had the largest growth over the last four years were gliptin + metformin, gliptin + metformin + sulfonylurea and flozin + metformin (See Figure 4).
- There are several examples of apparent use outside the PBS restriction. These are the use of flozins and gliptins together (See Figure 6) and the use of a flozin, gliptin or exenatide as monotherapy (See Figures 6, 8 and 13).
Full Report
[1] ABS Estimated residential population (ERP) as at 30 June 2016, using ABS Population Clock
[2] ABS ERP as at 30 June 2012, using ABS.Stat beta
