Features of population consumption of combined glucose-lowering drugs in pharmacy organizations of the Russian Federation

Objective : To study the characteristics of population consumption of combined glucose-lowering drugs (GLDs) in pharmacy organizations of the Russian Federation (RF) for the period from 2021 to 2023. Material and methods . Using the tools of pharmacoepidemiological monitoring, a multicenter study was conducted to assess the implementation of GLD fixed-dose combinations (FDCs) in the retail sector of the pharmaceutical market of 85 RF subjects. The range and volume of retail sales (in packages and rubles) of GLDs from 13 groups of the Anatomical Therapeutic Chemical Classification System (including FDCs) were analyzed using the database of the product range of medicines of the AlphaRM company (Russia). The content, comparative, systemic, retrospective, logical, and graphical analysis, as well as the methods of grouping and descriptive statistics were used. Results . The structure of retail sales was found to be dominated by foreign FDCs. Thus, out of the 16 FDCs included in the State Register of Medicinal Products, 12 are produced by foreign companies. A list of combinations of GLDs that have no Russian analogues was compiled, which includes “alogliptin + metformin”, “alogliptin + pioglitazone”, “vildagliptin + metformin”, “dapagliflozin + metformin”, etc. By the end of 2023, the volume of pharmacy sales of FDCs had amounted to 4,677 billion rubles (about 98% are sales of imported drugs). In the period from 2021 to 2023, the average retail price of 1 package of a combined drug increased from 927 to 1261 rubles, while the average retail price of 1 package of an imported drug was 5.5 times higher than that of the respective domestic drug. The share of FDCs in the structure of retail sales of GLDs (in physical terms, i.e., the number of packages) was about 8%. The most popular among pharmacy customers are imported combined drugs with metformin (Galvus® Met, Reduxin® Forte, Glibomet®, Glucovans®, Vipdomet®, Sigduolong®, Sinjardi®, Yanumet®), domestic drugs of the “metformin + glibenclamide” combination (Metglib® Force, Metglib®, Glibenclamide + Metformin®), as well as with other combinations (Glidica M® and Glimecomb®). When compiling the marketing profile of GLD FDC group, it was found that triple combinations of GLDs are not registered in the RF. This limits the ability of physicians to prescribe rational pharmacotherapy regimens. Conclusion . The results obtained can be used by healthcare managers when assessing the need for drugs prescribed for the treatment of diabetes; when planning funds allocated from federal and regional budgets for the provision of medicines to these categories of beneficiaries, as well as when developing measures for improving drug support for patients with diabetes. In addition, the results may serve as a basis for the development of programs aimed at supporting the domestic pharmaceutical industry.