Compared to traditional therapies, innovative drugs for the treatment of type 2 diabetes reduce the risk of death, dangerous cardiovascular events such as stroke, heart failure and heart attack by up to 37%, and also have a more favorable cost-effectiveness profile. This is highlighted by the retrospective observational study ‘Efficient’ (Effectiveness and cost-effectiveness profiles of healthcare pathways in type 2 diabetes mellitus: a real-life investigation through Italy) conducted on the administrative databases of two Regions (Lombardy and Sicily) and involved 40,959 people followed up between 2015 and 2020.
The results were presented during the seminar ‘New care pathways for patients with type 2 diabetes between innovation and sustainability’ promoted by Dephaforum. The study protocol was approved by the Ethics Committee of the Bicocca University of Milan and the analyzes were carried out by the Healthcare research and pharmacoepidemiology Unit of the Milanese university with Eehta-Ceis of the University of Rome Tor Vergata.
Diabetes has “a strong impact on the entire community. It has a prevalence of over 6% of the entire Italian population – says Francesco Saverio Mennini, president of Sihta, the Italian Society of Health Technology Assessment -. of a patient requires complex interventions for glycemic control, prevention of cardiovascular risk and management of complications.A recent study by the Eehta-Ceis of the University of Rome Tor Vergata – he continues – estimated that in our country the direct costs for diabetes are around 9 billion euros to which must be added the social and health costs for indirect effects, for a total of over 20 billion a year.In this perspective, the new antidiabetic agents introduced on the market in recent years and an increase in monitoring activities represent a resource for the patient and the entire community, reducing the impact of comorbidities, and of the pathology itself, and bringing the system s national welfare system to save around one billion euros every year”.
“Diabetes is one of the most widespread and frequent chronic conditions in Western countries – underlines Agostino Consoli, past president of the Italian Society of Diabetology -. In Italy there are a total of over 3.7 million patients. It is a pathology significantly associated with It is also estimated that about 40% of patients are affected by chronic kidney disease and there are other possible complications, including retinopathy”.
“The treatments available today include some innovative therapeutic approaches capable not only of controlling the glycemic level but also of reducing cardiovascular and renal complications – continues Riccardo Candido, head of the Diabetes Center of the Giuliano Isontina University Health Authority of Trieste -. The majority of patients receive metformin as initial therapy, followed by the addition of single oral medications for adequate glycemic control.The role of more innovative second-line antidiabetic agents such as Glp-1 receptor agonists, inhibitors of Dpp-4 and inhibitors of the Sglt-2 transporter.The new therapies undoubtedly present higher costs than traditional therapies such as those based on sulfonylurea and/or glinides”.
“This is also why we launched the Efficient study”, underlines Giovanni Corrao, scientific director of the study and director of the Interuniversity Center Healthcare research and pharmacoepidemiology.
“The study – adds Matteo Franchi, of the Bicocca University of Milan and responsible for data analysis – was conducted in two important national realities, one in the North (Lombardy) and one in the South (Sicily). The reference population amounts to over 15 million Italians: almost a quarter of all the inhabitants of the Peninsula.The results show that, compared to traditional therapies, the use of innovative drugs brings an advantage for patients by reducing their risk of death and hospitalization for major cardiovascular events between 25 and 37%.Furthermore – he continues – the higher cost of innovative drugs is offset by the reduction in expenditure for hospitalization, thus leading to a total reduction in the costs incurred by the health service.In summary, the study shows that the he second-line use of these innovative medicines has benefits for both patients and the health service.”
“About a third of patients are currently followed only by the general practitioner – recalls Gerardo Medea, National Head of the Metabolic Area of Simg, the Italian Society of General Medicine – After an important decision by the Medicines Agency, for almost a year also the of the family can prescribe innovative drugs. We are absolutely convinced that local medicine and primary care have the skills to increasingly take on the management of diabetic patients”.