AIMS To estimate and compare the prescription costs for the management of patients with diabetes over a period of 20 years in Greece, based on real world data. METHODS The records of outpatients with T2D, monitored at three diabetes centres, were examined in four cross-sections (1998, 2006, 2012, 2018). Prescribed medicines per patient, along with a set of clinical indicators were recorded. Annual costs of pharmaceutical treatment per patient were calculated by using each year's nominal retail prices, as well as by adjusting for 2018 price levels, in order to account for price differences over time. RESULTS 4066 patients were included in the analysis. Prescription patterns indicate a quick uptake of the new classes of glucose-lowering drugs and a reduction in the proportional use of sulfonylurea and glitazone. Adjusting for 2018 prices, the average total annual prescription cost per patient was 381.54 Euros (s.d. 297.44) in 1998 and 1147.21 Euros (s.d. 814.39) in 2018. Glucose-lowering drug costs per patient increase from 1998 onwards, whereas the costs of antihypertensive, antiplatelet and lipid-lowering treatment declined gradually, especially after 2006. CONCLUSIONS Per patient prescription costs for glucose-lowering drugs present a steep increase, in Greece over the last 20 years. Real-world evidence studies that compare this increase with the changes in patient outcomes are essential in order to examine whether a costs-vs-outcomes balance is optimal.

中文翻译：

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2型糖尿病处方费用的二十年趋势：希腊的实际数据和经验分析。

目的根据现实世界的数据，估计并比较希腊在20年内治疗糖尿病患者的处方费用。方法在四个横截面（1998年，2006年，2012年，2018年）检查了在三个糖尿病中心监测的门诊T2D患者的记录。记录每位患者的处方药以及一系列临床指标。通过考虑每年的名义零售价格以及通过调整2018年的价格水平来计算每位患者的年度药物治疗成本，以解决一段时间内的价格差异。结果分析纳入4066例患者。处方模式表明，新的降糖药物已被快速吸收，磺酰脲和格列酮的比例使用减少。调整2018年价格后，平均每位患者的年度处方总费用在1998年为381.54欧元（sd 297.44），在2018年为1147.21欧元（sd 814.39）。从1998年开始，每位患者降低葡萄糖的药物费用增加，而降压，抗血小板和降脂的费用治疗逐渐下降，尤其是在2006年之后。结论在过去20年中，希腊每位患者降低葡萄糖药物的处方费用呈急剧上升趋势。为了检查成本与结果的平衡是否最佳，将这些增加与患者预后的变化进行比较的现实证据研究是必不可少的。而降压，抗血小板和降脂治疗的费用则逐渐下降，尤其是在2006年之后。结论在过去20年中，希腊每位患者降糖药物的处方费用呈急剧上升趋势。为了检查成本与结果的平衡是否最佳，将这些增加与患者预后的变化进行比较的现实证据研究是必不可少的。而降压，抗血小板和降脂治疗的费用逐渐下降，尤其是在2006年之后。结论在过去20年中，希腊每位患者降糖药物的处方费用呈现急剧上升的趋势。为了检查成本与结果的平衡是否最佳，将这些增加与患者预后的变化进行比较的现实证据研究是必不可少的。