Type 2 diabetic disease and current drug treatments: clinical and governance aspects

Type 2 diabetes mellitus (T2D) is recognized as one of the most pressing global health issues of our time. In Italy, its prevalence has grown significantly, currently affecting an estimated 4 million individuals. Moreover, it is believed that an additional 1 million people may be living with the condition without a formal diagnosis, underscoring the critical need for enhanced awareness, screening, and preventive measures.

All drug dispensing data for T2M in the year 2023 were extrapolated from an internal management system in order to evaluate the consumption and expenditure data for these drugs in an Italian regional setting. The classes sought involve new high-cost drugs: Dipeptidyl Peptidase-4 (DPP-4) Inhibitors, Glucagon-like Peptide-1 (GLP1) Receptor Agonists, Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors.

A clear difference in the costs associated with each therapeutic class emerged, with important implications for the economic sustainability of the National Health Service (NHS). For the DPP4-inhibitor class, there was a value of total DDDs of 2,621,883, a total expenditure of €2,744,960.13; for the SGLT2-inhibitor class, there was a consumption value of total DDDs of 4,467,797 and a total expenditure of €6,702,941.75; GLP1- agonists, on the other hand, recorded a total DDD of 2,631,055.63, with an expenditure of €7,539,247.97.

The management of diabetic disease has seen a therapeutic evolution in recent years with increased effectiveness and rising costs of new drugs. For these reasons, it is of paramount importance that central governments adopt legislative measures to ensure greater therapeutic appropriateness that will ensure the sustainability of public health care.