Prescribing differences in family practice for diabetic patients in Germany according to statutory or private health insurance: the case of DPP-4-inhibitors and GLP-1-agonistsReport as inadecuate




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BMC Family Practice

, 17:146

Service organization, utilization, and delivery of care

Abstract

BackgroundThe objective of this study was to analyze prescription decisions for family practice FP patients with Diabetes mellitus type 2 DM2 using the case of the incretin mimetics Dipeptidyl peptidase-4 DDP-4 inhibitors and Glucagon-like peptide-1 GLP-1 agonists dependent on patients’ health insurance status statutory or private in Germany. This study is important since the scientific debate is still open with regard to DPP-4-inhibitors and GLP-1-agonists, where some critics are raising questions on potential long-term risks for patients.

MethodsData for this analysis were sourced from the German health services research register CONTENT CONTinuous morbidity registration Epidemiologic NeTwork, in which FP health services information, generated by family practitioners, is continuously collated, e.g. patients’ health insurance status, morbidity and pharmacotherapy. Patients with Diabetes mellitus type 1 DM1 were excluded from the study.

ResultsFrom the family practices collaborating in the CONTENT research network, there were 7298 patients treated with pharmacotherapeutic agents for DM2 between 01.09.2009 and 31.08.2014. 586 8.03 % of these patients had private insurance. Prescriptions for the incretin mimetics were 40.6 % higher 9.7 vs. 6.9 %; p < 0.0001 for patients with private insurance compared to patients with statutory health insurance. This finding was confirmed with multivariable analyses.

ConclusionsThere was a statistically significant difference found in prescription patterns according to the patient’s health insurance status for the incretin mimetics in this sample population of German patients with DM2. Obviously, these differences result from the eligibility for reimbursement according to patients’ health insurance status. Whether incretin mimetics pose specific long term risks for particular patients is yet to be determined.

AbbreviationsBMBF-Bundesministerium fuer Bildung und Forschung - Federal Ministry of Education and Research

CIConfidence Interval

CONTENTCONTinuous morbidity registration Epidemiologic NeTwork

DDP-4Dipeptidyl peptidase-4

DM1Diabetes mellitus type 1

DM2Diabetes mellitus type 2

EMAEuropean Medicines Agency

FDAFood and Drug Administration

FPFamily Practitioner

GLP-1Glucagon-like peptide-1

n. s.not significant

OROdds Ratio

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Author: Gunter Laux - Sarah Berger - Joachim Szecsenyi - Petra Kaufmann-Kolle - Rüdiger Leutgeb

Source: https://link.springer.com/







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