Impact of co-payment level increase of antidiabetic medications on glycaemic control: an interrupted time-series study among Finnish patients with type 2 diabetes
Abstract Background A new special reimbursement scheme (SRS) for non-insulin medications used for treatment of hyperglycaemia in type 2 diabetes (T2D) was implemented in Finland on January 1, 2017. The new SRS affected all community-dwelling Finnish T2D patients as all community-dwelling residents a...
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ftdoajarticles:oai:doaj.org/article:ed9c2414c44e459ab84b9b601eb0baf5 2023-05-15T17:00:15+02:00 Impact of co-payment level increase of antidiabetic medications on glycaemic control: an interrupted time-series study among Finnish patients with type 2 diabetes Piia Lavikainen Emma Aarnio Kari Jalkanen Hilkka Tirkkonen Päivi Rautiainen Tiina Laatikainen Janne Martikainen 2020-11-01T00:00:00Z https://doi.org/10.1186/s12913-020-05952-6 https://doaj.org/article/ed9c2414c44e459ab84b9b601eb0baf5 EN eng BMC https://doi.org/10.1186/s12913-020-05952-6 https://doaj.org/toc/1472-6963 doi:10.1186/s12913-020-05952-6 1472-6963 https://doaj.org/article/ed9c2414c44e459ab84b9b601eb0baf5 BMC Health Services Research, Vol 20, Iss 1, Pp 1-10 (2020) Type 2 diabetes Co-payment increase Glycaemic control Public aspects of medicine RA1-1270 article 2020 ftdoajarticles https://doi.org/10.1186/s12913-020-05952-6 2022-12-31T05:56:38Z Abstract Background A new special reimbursement scheme (SRS) for non-insulin medications used for treatment of hyperglycaemia in type 2 diabetes (T2D) was implemented in Finland on January 1, 2017. The new SRS affected all community-dwelling Finnish T2D patients as all community-dwelling residents are eligible for reimbursement for prescription medications. The aim of the study was to evaluate the impact of this co-payment increase on glycaemic control among Finnish T2D patients. Methods Data on glycaemic control were collected with HbA1c measures from electronic health records from primary health care and specialized care in the North Karelia region, Finland, from patients with a confirmed T2D diagnosis in 2012 who were alive on January 1, 2017 (n = 8436). Average HbA1c levels were measured monthly 36 months before and 33 months after the policy change. Consumption of diabetes medications was measured with defined daily doses (DDDs) based on reimbursed medication purchases. Interrupted time series design analysed with segmented regression model was applied to examine the effect of the policy change on average HbA1c levels. Results Eight thousand one hundred forty-three T2D patients had at least one HbA1c measurement within 01/2014–9/2019. Mean age of the patients was 68.1 (SD 11.3) years and 53.0% were women. Average time since T2D diagnosis was 11.5 (SD 6.1) years. An estimated increase of 0.81 (95% confidence interval, CI, 0.04–1.58) mmol/mol in average HbA1c levels was detected at the time of the policy change. In subgroup analyses, strongest effects were detected among patients who used only other diabetes medications than insulin or metformin in 2016 (3.56 mmol/mol, 95% CI 2.50–4.62). Meanwhile, yearly consumption of diabetes medications decreased slightly from 618.9 (SD 487.8) DDDs/patient in 2016 to 602.9 (SD 475.6) DDDs/patient in 2017 (p = 0.048). Conclusions Simultaneously with the increase of the co-payment level, the average HbA1c level increased among T2D patients from the North Karelia region, ... Article in Journal/Newspaper karelia* Directory of Open Access Journals: DOAJ Articles BMC Health Services Research 20 1 |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Type 2 diabetes Co-payment increase Glycaemic control Public aspects of medicine RA1-1270 |
spellingShingle |
Type 2 diabetes Co-payment increase Glycaemic control Public aspects of medicine RA1-1270 Piia Lavikainen Emma Aarnio Kari Jalkanen Hilkka Tirkkonen Päivi Rautiainen Tiina Laatikainen Janne Martikainen Impact of co-payment level increase of antidiabetic medications on glycaemic control: an interrupted time-series study among Finnish patients with type 2 diabetes |
topic_facet |
Type 2 diabetes Co-payment increase Glycaemic control Public aspects of medicine RA1-1270 |
description |
Abstract Background A new special reimbursement scheme (SRS) for non-insulin medications used for treatment of hyperglycaemia in type 2 diabetes (T2D) was implemented in Finland on January 1, 2017. The new SRS affected all community-dwelling Finnish T2D patients as all community-dwelling residents are eligible for reimbursement for prescription medications. The aim of the study was to evaluate the impact of this co-payment increase on glycaemic control among Finnish T2D patients. Methods Data on glycaemic control were collected with HbA1c measures from electronic health records from primary health care and specialized care in the North Karelia region, Finland, from patients with a confirmed T2D diagnosis in 2012 who were alive on January 1, 2017 (n = 8436). Average HbA1c levels were measured monthly 36 months before and 33 months after the policy change. Consumption of diabetes medications was measured with defined daily doses (DDDs) based on reimbursed medication purchases. Interrupted time series design analysed with segmented regression model was applied to examine the effect of the policy change on average HbA1c levels. Results Eight thousand one hundred forty-three T2D patients had at least one HbA1c measurement within 01/2014–9/2019. Mean age of the patients was 68.1 (SD 11.3) years and 53.0% were women. Average time since T2D diagnosis was 11.5 (SD 6.1) years. An estimated increase of 0.81 (95% confidence interval, CI, 0.04–1.58) mmol/mol in average HbA1c levels was detected at the time of the policy change. In subgroup analyses, strongest effects were detected among patients who used only other diabetes medications than insulin or metformin in 2016 (3.56 mmol/mol, 95% CI 2.50–4.62). Meanwhile, yearly consumption of diabetes medications decreased slightly from 618.9 (SD 487.8) DDDs/patient in 2016 to 602.9 (SD 475.6) DDDs/patient in 2017 (p = 0.048). Conclusions Simultaneously with the increase of the co-payment level, the average HbA1c level increased among T2D patients from the North Karelia region, ... |
format |
Article in Journal/Newspaper |
author |
Piia Lavikainen Emma Aarnio Kari Jalkanen Hilkka Tirkkonen Päivi Rautiainen Tiina Laatikainen Janne Martikainen |
author_facet |
Piia Lavikainen Emma Aarnio Kari Jalkanen Hilkka Tirkkonen Päivi Rautiainen Tiina Laatikainen Janne Martikainen |
author_sort |
Piia Lavikainen |
title |
Impact of co-payment level increase of antidiabetic medications on glycaemic control: an interrupted time-series study among Finnish patients with type 2 diabetes |
title_short |
Impact of co-payment level increase of antidiabetic medications on glycaemic control: an interrupted time-series study among Finnish patients with type 2 diabetes |
title_full |
Impact of co-payment level increase of antidiabetic medications on glycaemic control: an interrupted time-series study among Finnish patients with type 2 diabetes |
title_fullStr |
Impact of co-payment level increase of antidiabetic medications on glycaemic control: an interrupted time-series study among Finnish patients with type 2 diabetes |
title_full_unstemmed |
Impact of co-payment level increase of antidiabetic medications on glycaemic control: an interrupted time-series study among Finnish patients with type 2 diabetes |
title_sort |
impact of co-payment level increase of antidiabetic medications on glycaemic control: an interrupted time-series study among finnish patients with type 2 diabetes |
publisher |
BMC |
publishDate |
2020 |
url |
https://doi.org/10.1186/s12913-020-05952-6 https://doaj.org/article/ed9c2414c44e459ab84b9b601eb0baf5 |
genre |
karelia* |
genre_facet |
karelia* |
op_source |
BMC Health Services Research, Vol 20, Iss 1, Pp 1-10 (2020) |
op_relation |
https://doi.org/10.1186/s12913-020-05952-6 https://doaj.org/toc/1472-6963 doi:10.1186/s12913-020-05952-6 1472-6963 https://doaj.org/article/ed9c2414c44e459ab84b9b601eb0baf5 |
op_doi |
https://doi.org/10.1186/s12913-020-05952-6 |
container_title |
BMC Health Services Research |
container_volume |
20 |
container_issue |
1 |
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1766052893300883456 |