Perceived use and comparison of usage of sitagliptin and vildagliptin in Miri Hospital

Abstract

Introduction: Malaysia has the highest rate of diabetes in Asia. Patients with diabetes normally will initially treat with lifestyle intervention and followed by pharmacological treatment. Dipeptidyl peptidase-4 (DPP-4) inhibitors are a newer class of oral diabetes drugs that has recently gain attention in treating diabetes through increases and prolonged incretin hormone activity which in turn helps to increase release of insulin and minimize glucagon secretion. A study was carried out in Medical outpatient clinic of Miri Hospital in year 2016 and 2017 to find out the average maintenance dose per day (or Defined Daily Dose, DDD) for two selected DPP-4 inhibitors, namely vildagliptin and sitagliptin for adults diagnosed with type 2 diabetes.

Methods:

The data collected measured in daily defined dose (DDD) which is the average maintenance dose per day for a drug used for its main indication in adults. The processed and total dose of each pharmaceutical agent linked to appropriate ATC code and DDD from WHO ARC/DDD system. The drug utilisation for both sitagliptin and vildagliptin compared based on DDD per 1000 inhabitants to provide rough estimate of the proportion of patients in Medical outpatient clinic of Miri Hospital treated with sitagliptin and vildagliptin.

Results:

Overall usage of DPP-4 inhibitors in Hospital Miri increased by about 6% from 2016 to 2017. The number of prescribed vildagliptin increased by 167.3%% from 0.098 DDD/1000 inhabitants/day to 0.262 DDD/1000 inhabitants/day while sitagliptin reduce by 22.3% from 0.555 DDD/1000 inhabitants/day to 0.431 DDD/1000 inhabitants/day from 2016 to 2017. Prescribers had slowly shifted their preference over to vildagliptin because it is cheaper and it shown to be more effective in term of glycemic control when compared to sitagliptin. However, sitagliptin still preferred over vildagliptinin 2016 to 2017 as it was the first DPP-4 inhibitor approved to be used in Malaysia.

Conclusion:

Sitagliptin was more frequently prescribed than vildagliptin in Hospital Miri. However, the proper utilisation pattern was not clear due to money constraint, leading to restricted usage of both DPP-4 inhibitors. Hence, they were reserved for certain group of patients and depend on the preference of prescribers.