Trends in use and costs of prescription medication in patients with type 1 diabetes: 9-year follow-up after kidney transplantation

作     者：Raija Lithovius Valma Harjutsalo Carol Forsblom Markku Saraheimo Petri Koskinen Per-Henrik Groop 

作者机构：Folkhalsan Institute of GeneticsFolkhalsan Research CenterHelsinkiFinland Department of MedicineDivision of NephrologyHelsinki University Central HospitalHelsinkiFinland National Institute for Health and WelfareDiabetes Prevention UnitHelsinkiFinland The Baker IDI Heart and Diabetes InstituteMelbourneAustralia 

出 版 物：《Journal of Diabetes Mellitus》 (糖尿病（英文）)

年 卷 期：2013年第3卷第1期

页      面：1-10页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Folkhalsan Research Foun- dation Wilhelm and Else Stockmann Foundation Liv och Halsa Foun- dation Kidney Foundation 

主　　题：Immunosuppressants Kidney Transplantation Medication Utilization Costs Prescription Medications Type 1 Diabetes 

摘      要：Aims: Weestimated long-term trends in prescription medication utilization and costs in patients with type 1 diabetes in two different transplant cohorts (Group 1: transplantation 1986-1999,n = 180;Group 2: transplantation 2000-2008, n = 150). Methods: Data obtained from the Finnish Diabetic Nephropathy Study were linked with the Drug Prescription Register (purchases of medications 1995-2009). Generalized linear mixed models under gamma distribution were used to evaluate the medication costs. Results: The total costs of medication decreased (Group 1 from€11,290 to €8760;Group 2 from €12,800 to €9790)during the follow-up (P 0.0001). The sametrend was observed for immunosuppressive drugcosts (P 0.0001). Although the cost profiles were similar for the groups (P= 0.9), the cost level in Group 2 was higher than in Group 1 (P 0.0001). In Group 1 the most common immunosuppressive combination was cyclosporine, azathioprine and corticosteroid, while cyclosporine, mycophenolate mofetil (MMF) with/without corticosteroid was the most common in Group 2. The estimated average costs of cyclosporine in combination withMMFwere 84% (€4130) higher than with azathioprine. Conclusions: Since diabetes or other drugs had only marginal impact on the total costs, the decreasing trend wasmainly due to the costs of *** finding is consistent with the recent guidelines which recommend reducing doses of immunosuppressants over time to minimize *** cost levels differed depending on the combinations of immunosuppressive drugs in use. Those who had MMF in the regimen generated higher costs.