Trends in global glucose lowering medication consumption: Insights from pharmaceutical sales data (2010–2021)

Diabetes imposes a substantial global burden. Examining consumption trends of glucose lowering medications can help facilitate cross-country comparisons and uncover areas of unmet need. Leveraging IQVIA MIDAS data, our analysis spans 72 countries and 2 regions from 2010 to 2021, employing defined daily dose (DDD) as a consumption metric. We assessed consumption trends across income tiers and individual country rankings, exploring WHO essential medicines, insulin, new drug classes and specific drugs, with further analyses on their correlation with treatment guideline releases. Global glucose lowering medication consumption rate increased from 39.2 to 54.0 DDD per thousand inhabitants per day (DDD/TID) between 2010 and 2021. Across the same period, median consumption rates were 60.1 DDD/TID [IQR, 46.5-70.6] in high-income countries (HICs), 26.9 DDD/TID [IQR, 8.0-51.3] in upper-middle income countries (UMICs) and 10.8 DDD/TID [IQR, 6.5-18.5] in low- and lower-middle income countries (LMICs). While the most significant consumption changes occurred in UMICs and LMICs such as Bosnia, China and Indonesia, HICs such as Finland, Canada and USA consistently showed the highest consumption rates. Over the study period, the median consumption rates for essential medicines, insulin and new drug classes increased, except for intermediate-acting insulin and soluble insulin/biosimilars. HICs drove the consumption of fast-acting and long-acting insulin and new drug classes, whereas UMICs and LMICs drove the consumption of intermediate-acting insulin. This study sheds light on the global variations in glucose lowering medication consumption, providing insights to address access gaps, particularly in UMICs and LMICs.