Population-based trends in antidiabetic medication utilization during the COVID-19 pandemic: results from the PANDUTI-TR study.

AIM: We aimed to examine changes in antidiabetic drug utilization associated with implementation and subsequent easing of pandemic-related restrictions.

BACKGROUND

The COVID-19 pandemic and associated restrictions disrupted healthcare access and glycemic regulation, affecting diabetes management.

METHODS

We collected nationwide outpatient antidiabetic drug sales and projected prescribing data from IQVIA Turkey between 01.03.2018 and 31.12.2022. We assessed average monthly consumption, expenditure, and quarterly prescribing trends across 'before restrictions' (BfR, 01.03.2018-31.03.2020), 'during restrictions' (DuR, 01.04.2020-31.03.2022), and 'after restrictions' (AfR, 01.04.2022-31.12.2022) periods. Consumption and prescribing levels were expressed as 'defined daily doses/1,000 inhabitants/day' (DID).

RESULTS

Antidiabetic consumption increased from 123.6 ± 12.2 DID in BfR to 156.3 ± 25.4 DID in DuR and remained elevated in AfR (151.2 ± 28.9 DID), paralleled by expenditure (€63.6 m ± 8.4 m, €85.1 m ± 14.8 m, and €83.9 m ± 19.1 m, respectively). Prescribing levels declined from BfR to DuR (56.4 ± 3.5 to 29.9 ± 3.6 DID, p < 0.001) and slightly recovered in AfR (46.0 ± 10.9 DID, p > 0.05 vs. earlier periods). Oral antidiabetic consumption rose from 71.2 ± 6.8 DID in BfR to 90.6 ± 17.2 DID in DuR (p < 0.001) and further to 96.9 ± 19.4 DID in AfR (p < 0.001 vs. BfR), while sodium-glucose cotransporter-2 inhibitor use increased across periods (p < 0.001). Injectable antidiabetic consumption, mainly insulins, increased from BfR to DuR (p < 0.001), and decreased in AfR (p < 0.01 vs. DuR).

CONCLUSION

We demonstrated a sustained increase in antidiabetic consumption following implementation of COVID-19-related restrictions, persisting beyond easing of most measures. Medication-access policies, panic stockpiling, improved glycemic adherence, and newer therapies might have contributed. These findings may inform strategies to strengthen family physician-community pharmacist coordination while maintaining treatment continuity and optimizing medication access during future public health emergencies.