Anti-diabetic drugs utilization pattern and its cost in managing Type 2 Diabetes patients in hospitals in Selangor, Malaysia

Introduction: Increasing prevalence of Type 2 Diabetes Mellitus (T2DM) worldwide has been reported in numerous studies. This issue has a significant effect on population quality of life as well as the economic burden in managing the disease. Policy makers have promoted the adoption of a Health Information System (HIS) to facilitate the coordination of medical care. Major hospitals in Selangor, Malaysia are using the HIS as their Electronic Medical Records (EMR). This study is the first attempt to extract data in HIS with the aim to turn data from the HIS into clinical information and to provide evidence for hospital management. Objective: The study aims to describe the antidiabetic drugs utilization pattern and its cost for T2DM in three hospitals equipped with a HIS. Methodology: This study was conducted in 2014 by using secondary data analysis of T2DM patients receiving diabetic medications in three public hospitals in Selangor, Malaysia that are utilizing the same software for their electronic HIS. Patients’ data from January to December 2013 were included in the analysis and were analyzed by using STATA v12. Outpatient, pharmacy, and laboratory dataset were cleaned and merged for data analysis. Results: The data shows prescription patterns for Hospital A are 28.5% monotherapy, 26.9% a combination of 2 oral drugs, and 22.3% a combination of insulin and oral drugs. The pattern is slightly similar to Hospital C where 29.6% of monotherapy, 24.4% of a combination of 2 oral drugs and 23.3% of a combination of insulin and oral drugs. Meanwhile for Hospital B, 30.1% of a combination of insulin and oral drugs, 29.4% of a combination of 2 oral drugs and 29% of monotherapy. The mean cost per patient in 2013 of antidiabetic agents (ADA) for Hospital A is RM 191.21 ± 269.64, Hospital B is RM 217.17 ± 385.49 and for Hospital C is RM 252.28 ± 384.35. Conclusion: Monotherapy, metformin predominantly has been prescribed as a first line treatment for T2DM. The prescribing trend was followed by using a combination therapy of oral hypoglycemic agents (OHA) an then, insulin and OHA. Therefore, this study showed that drugs at low cost have been prescribed commonly in all hospitals studied. Keywords: Utilization, Drugs, Diabetes, Malaysia, HIS, Hospita