چکیده (انگلیسی):

Objectives: New antidiabetic medications such as insulin analogues and thiazolidinediones have been introduced
over the last decade. This study compares the uptake of new agents in three emerging pharmaceutical markets:
Brazil, China, and Thailand.
Methods: Using longitudinal IMS Health sales data, we calculated the quarterly percentage market share for types
of insulins and oral hypoglycemic agents from 2002 through 2012 in each country. New oral hypoglycemic agents
included: alpha-glucosidase inhibitors, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, and non-sulfonylurea
secretagogues.
Results: While China had the highest use of insulin cartridges and pens (85.6% in 2010), Brazil was the earliest
adopter of insulin analogues and had the greatest use of these products overall (44.6% of the insulin market) in
2010, which then decreased by almost half by 2012. Together, sulfonylureas and metformin dominated the markets
in Brazil and Thailand (~89% and ~96% respectively) over the 10-year period. Between 2002 and 2012, there was a
shift in use from sulfonylureas to metformin; the market share of newer agents remained 10% or less in both
countries. In China, however, market share of new oral agents grew rapidly from 13.1% to 44.4%. While metformin
use was relatively stable in China (one-third of the market), sulfonylureas declined substantially over the 10-year
period (41.5% to 20.8%).
Conclusion: Given large cost differentials between newer and older insulins and among oral hypoglycemic agents,
it is important to evaluate uptake of newer products over time. Uptake patterns differed in the study countries,
likely due to different medicines policy approaches. Future research should evaluate how trends in use of
antidiabetic products align with national clinical practice guidelines and pharmaceutical policies, as well as the
impacts of different patterns of use on cost and clinical outcomes.