Essential Diabetes Medicines and Health Outcomes in 127 Countries
| Autor: | Darshanand Maraj, Nav Persaud, Dalton R. Budhram, Ri Wang, Krish Bilimoria, Simran Benipal |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Endocrinology
Diabetes and Metabolism 030209 endocrinology & metabolism Population health 030204 cardiovascular system & hematology Essential medicines 03 medical and health sciences 0302 clinical medicine Endocrinology Interquartile range Diabetes mellitus Environmental health Outcome Assessment Health Care medicine Per capita Diabetes Mellitus Internal Medicine Humans Developing Countries Cause of death business.industry 1. No poverty General Medicine medicine.disease Confidence interval Health equity 3. Good health Cross-Sectional Studies business Drugs Essential |
| Zdroj: | Canadian Journal of Diabetes. 46:S4 |
| ISSN: | 1499-2671 |
| Popis: | Aim Diabetes is the ninth leading cause of death. Improving access to diabetes medicines may decrease mortality. Diabetes medicines on national essential medicines lists (NEMLs) vary considerably. We examine the association between diabetes population health outcomes, relating to mortality, and the listing of diabetes medicines on national essential medicine lists for 127 countries. Materials and methods We conducted a cross-sectional study. We determined the number of diabetes medicines on NEMLs and used multiple linear regression to analyze the association between diabetes health outcomes and the number of medicines on NEMLs. We used linear regression to assess the association between diabetes health outcomes and the listing or not listing of medicines that were listed by 25% to 75% of countries. Diabetes prevalence, gross domestic product (GDP) per capita and mean expenditure per person with diabetes were controlled for in all analyses. Results The total number of diabetes medicines listed on NEMLs ranged from 0 to 16 (median: 4; interquartile range: 3 to 6). Diabetes health outcome scores were associated with the number of diabetes medicines on NEMLs (1·3-point increase [95% Confidence Interval, 95% CI 0·5-2·1] for every additional medicine on NEMLs; p = 0·002) and GDP per capita (19·5-point increase [95% CI 5·4 to 33·6] for every 10-fold increase in GDP; p = 0·003). Diabetes expenditure was not associated with health outcome scores (p = 0·23). Increases in diabetes health outcomes score were associated with the listing of glimepiride (7·9-point increase 95% CI 2·3-13·5, p = 0.006) and glipizide (5·8-point increase 95% CI 0·03-11·6, p = 0·049) on NEMLs. Conclusions Listing of diabetes medicines on NEMLs has the potential to improve population health outcomes related to mortality in countries with diverse incomes and diabetes prevalence without necessarily increasing diabetes health expenditure. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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