OBJECTIVE To systematically analyze the utilization and application trends of hypoglycemic drugs in National and Fujian medical and health institutions, and to provide reference for rationally adjusting the structure and formulating relevant policies.
METHODS Based on national drug usage monitoring data from 47 096 medical and health institutions, a system analysis of the utilization of hypoglycemic drugs was used by defined daily dose analysis through indicators such as medication frequency, limited daily cost, and ranking ratio.
RESULTS In 2021, the largest proportion of non-insulin hypoglycemic drugs in the country was metformin(29.90%), followed by sulfonylureas(25.02%) and alpha-glucosidase inhibitors(17.16%). Sulfonylureas(36.10%) accounted for the largest proportion of consumption in primary medical and health institutions. The largest proportion of drugs used in Fujian was sulfonylureas(28.70%). The highest proportion of defined daily doses among insulin-based hypoglycemic drugs in the country was premixed insulin(48.10%), followed by long-acting(26.62%), short-acting(13.71%), rapid-acting(9.78%) and intermediate-acting insulin(1.79%). However, long-acting insulin accounted for the highest proportion in tertiary hospitals(37.41%). From 2021 to 2023, metformin accounted for the largest proportion in tertiary hospitals in Fujian. After a significant initial increase, the proportion of dipeptidyl peptidase IV inhibitor usage subsequently declined. In contrast, the proportion of sodium-glucosecotransporter 2 inhibitor usage had shown a substantial year-on-year rise. The usage of glucagon-likepeptide-1 receptor agonist had increased to a lesser extent, while the proportion of sulfonylurea usage dropped sharply before experiencing a slight rebound. The proportion of long-acting insulin usage remained stable, rapid-acting insulin increased, while premixed insulin decreased year by year.
CONCLUSION The use of hypoglycemic drugs in medical institutions across the country and Fujian is basically consistent with the recommendations of relevant guidelines. The role of the national policy of organizing centralized volume-based procurement to benefit the people has been highlighted, and the average daily cost of hypoglycemic drugs has dropped significantly. Evidence-based evidence is increasingly becoming an important basis for correct clinical selection of drugs, but must also be paid to the optimization of the medication structure of hypoglycemic drugs in primary medical and health institutions.