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Socioeconomic aspects of incretin-based therapy.

TitleSocioeconomic aspects of incretin-based therapy.
Publication TypeJournal Article
Year of Publication2023
AuthorsKaragiannis, T., Bekiari E., & Tsapas A.
JournalDiabetologia
Volume66
Issue10
Pagination1859-1868
Date Published2023 Oct
ISSN1432-0428
KeywordsDiabetes Mellitus, Type 2, Dipeptidyl-Peptidase IV Inhibitors, Glucagon-Like Peptide 1, Glucagon-Like Peptide-1 Receptor, Humans, Hypoglycemic Agents, Incretins, Socioeconomic Factors
Abstract

Incretin-based therapies, particularly glucagon-like peptide-1 receptor agonists (GLP-1 RAs), have demonstrated cardiovascular benefits in people with type 2 diabetes. However, socioeconomic disparities in their uptake may constrain the collective advantages offered by these medications to the broader population. In this review we examine the socioeconomic disparities in the utilisation of incretin-based therapies and discuss strategies to address these inequalities. Based on real-world evidence, the uptake of GLP-1 RAs is reduced in people who live in socioeconomically disadvantaged areas, have low income and education level, or belong to racial/ethnic minorities, even though these individuals have a greater burden of type 2 diabetes and cardiovascular disease. Contributing factors include suboptimal health insurance coverage, limited accessibility to incretin-based therapies, financial constraints, low health literacy and physician-patient barriers such as provider bias. Advocating for a reduction in the price of GLP-1 RAs is a pivotal initial step to enhance their affordability among lower socioeconomic groups and improve their value-for-money from a societal perspective. By implementing cost-effective strategies, healthcare systems can amplify the societal benefits of incretin-based therapies, alongside measures that include maximising treatment benefits in specific subpopulations while minimising harms in vulnerable individuals, increasing accessibility, enhancing health literacy and overcoming physician-patient barriers. A collaborative approach between governments, pharmaceutical companies, healthcare providers and people with diabetes is necessary for the effective implementation of these strategies to enhance the overall societal benefits of incretin-based therapies.

DOI10.1007/s00125-023-05962-z
Alternate JournalDiabetologia
PubMed ID37433896
PubMed Central IDPMC10474181

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