Journal of Clinical and Diagnostic Research. 2025 Jan, Vol-19(1): FC01-FC04 1 1 DOI: 10.7860/JCDR/2025/75320.20527 Original Article Pharmacology Section Pharmacoeconomics and Utilisation of Antidiabetic Medications among Type 2 Diabetes Mellitus Patients: A Longitudinal Study BIKASH CHANDRA DAS 1 , P ANSUMAN ABHISEK 2 , DEEPAK CHOUDHARY 3 , SUVENDU KUMAR PANDA 4 , JAYANTI PRAVA BEHERA 5 , SUPRIYA PRADHAN 6 , TRUPTI REKHA SWAIN 7 , SASMITA MALLICK 8 ABSTRACT Introduction: Patients with Type 2 Diabetes Mellitus (T2DM) typically require long-term treatment with antidiabetic medications, resulting in a significant financial burden on both the individual and the global economy. Aim: To assess the patterns of drug utilisation and the economic aspects of antidiabetic medications in individuals with diabetes mellitus. Materials and Methods: The current study was a hospital- based longitudinal study conducted between October 2017 and September 2019. A total of 132 diagnosed cases of T2DM, aged 18 years and older, who had been on antidiabetic medications in the past three months, were included in the study. Pregnant women and patients in diabetic coma were excluded from the study. A predesigned, pretested, semistructured questionnaire was used to collect data from the patients or their legally accepted relatives. The subjects were followed-up at three and six months to determine any changes in the type and doses of medication. Laboratory parameters such as Fasting Blood Sugar (FBS) and Postprandial Blood Sugar (PPBS) were measured at baseline and at six months, along with a history of any complications of diabetes. The data were analysed using Statistical Package for the Social Sciences (SPSS) version 27.0. Results: A total of 132 patients were included, of which most patients were male (65.9%), aged 60 years or above (50.8%), illiterate (79.5%), and resided in rural areas (94.7%). The Average Cost-Effectiveness Ratio (ACER) for reducing a unit of FBS was higher compared to PPBS across all forms of the drug. The ACER at three months showed a constant increase, from 24.56 for metformin only to 2709.26 for insulin with Oral Hypoglycaemic Agents (OHA) for FBS, and from 7.83 for metformin only to 907.47 for insulin with OHA for PPBS. Metformin was the most commonly prescribed medication, both as a standalone therapy and in combination therapy. Conclusion: Present investigation showed that rational prescribing effectively reduced blood sugar readings. Metformin and Glimepiride were the predominant pharmaceuticals utilised for the treatment of diabetes. The cost-effectiveness study indicates that the financial burden of diabetes is substantial, particularly when considering the socio-economic status of individuals. Keywords: Cost-effectiveness analysis, Metformin, Pharmaceuticals INTRODUCTION High blood glucose levels characterise a collection of metabolic illnesses known as diabetes mellitus. T2DM is a heterogeneous disorder marked by varying levels of insulin resistance, reduced insulin secretion, and heightened glucose synthesis by the liver [1]. The main cause of diabetes-related morbidity is the long-term consequences of sustained high blood sugar levels, such as microvascular and macrovascular complications. Consistent management of blood glucose levels and treatment of accompanying conditions, including hypertension and dyslipidaemia, can help alleviate these long-term consequences [2]. T2DM is a significant factor in the increasing prevalence of non communicable diseases in both industrialised and developing countries. The International Diabetes Federation Atlas (2017) projects that diabetes affects approximately 451 million individuals aged 18 years and over worldwide, with a projected increase to 693 million by 2045 [3]. Diabetes prevalence in India currently stands at 32.7 million. Projections indicate that this figure will rapidly increase to 124.9 million by 2045 [4]. In 2017, approximately 4.0 million people died worldwide due to diabetes and its complications. The cost of managing diabetes increased from 237 billion USD in 2007 to 727 billion USD in 2017 [3]. Patients with T2DM typically require long-term treatment with antidiabetic medications, resulting in a significant financial burden on both the individual and the global economy. The elderly face health economic challenges and social assistance issues [4]. Older diabetics frequently have co-morbidities that necessitate the use of multiple medications. Moreover, physiological differences in elderly individuals can lead to variations in the absorption, distribution, metabolism, and elimination of medications, as well as their effects on the body. As a result, the elderly often experience inappropriate medicine use, illogical prescribing, Adverse Drug Reactions (ADRs), and non compliance due to economic and health concerns [4]. Therefore, it is essential to address these issues and develop strategies for prescription medication for the elderly. Rational prescribing ensures that pharmaceuticals are suitable for their specific clinical indications, at the appropriate dosage, for a sufficient duration, and at the most cost-effective price for both the patient and the community. Drug utilisation studies support this. According to the World Health Organisation (WHO), drug utilisation encompasses various aspects of drug management in society, including prescription, dispensing, ingestion, marketing, distribution and usage. It primarily focuses on the subsequent health, societal and economic outcomes. These studies are essential because they encourage us to think critically about new drugs that come to the market, the wide range of prescription and usage patterns for drugs, concerns about delayed ADRs, and how the costs of drugs and therapies are increasing [5,6].