Dispensing patterns and cost of glucose-lowering therapies in diabetes mellitus patients at a tertiary care hospital in Southern India

Trends in the prescription pattern change periodically with the advent and introduction of novel drugs, changing insights and regular revision of national and international guidelines. We sought to determine the prescribing patterns and cost of antidiabetic drug in South Indian population. Retrospective collection of data in diabetic cohorts was carried. A total of 200 diabetic patients who have attended the diabetic clinic, KMC, Attavar, Mangalore were collected from the hospital records with 100 patients each in the years 2005 and 2010. The data collected for each patient was-demographic data, associated comorbidities, fasting and postprandial blood glucose levels, Hba1c, antidiabetic medications and investigations performed during each visit. Drug therapy adviced during each visit were collected and total cost per visit was calculated. Compared to diabetic patients in the year 2005 the number of diabetic patients above the age 60yr and patients with comorbidities were more in 2010. Dispensing pharmacy data indicate significant decrease in the prescription of sulfonylurea in 2010 compared to 2005. There was only marginal increase in total direct cost per visit since five years. Average cost per visit in 2005 was Rs.363 and Rs.377 in 2010. Among patients with one or more comorbidities there was 87 rupees increase in the cost per visit in 2010 compared to 2005. Prescription of monotherapy with sulfonylurea was significantly reduced in 2010 compared to prescriptions in the year 2005. The cost per visit remained same at both the years at Rs.377. Nevertheless, this is considered high particularly in developing countries like India and requires serious reforms to reduce the cost.