Preventive Metformin Monotherapy Medication Prescription, Redemption and Socioeconomic Status in Hungary in 2018–2019: A Cross-Sectional Study

Csilla Nagy, Attila Juhász, Péter Pikó, Judit Diószegi, György Paragh, Zoltán Szabó, Orsolya Varga and Róza Ádány
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Csilla Nagy: Public Health Administration Service of Government Office of Capital City Budapest, 1138 Budapest, Hungary
Attila Juhász: Public Health Administration Service of Government Office of Capital City Budapest, 1138 Budapest, Hungary
Péter Pikó: MTA-DE-Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary
Judit Diószegi: MTA-DE-Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary
György Paragh: Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
Zoltán Szabó: Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
Orsolya Varga: Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary
Róza Ádány: MTA-DE-Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary

IJERPH, 2021, vol. 18, issue 5, 1-11

Abstract: This study was designed to characterize the spatial distribution of metformin medication used as first-line monotherapy for prevention of T2DM in relationship with the socioeconomic status (level of deprivation) and T2DM mortality at district level in a nationwide cross-sectional ecological study for the first time in a European country, Hungary. Risk analysis was used to estimate the relationships between socioeconomic status, characterized by tertiles of deprivation index, and mortality caused by diabetes, and metformin medication (both prescription and redemption) for the years of 2018 and 2019 at the district level. The spatial distribution of districts with a higher relative frequency of metformin prescriptions and redemptions showed a positive correlation with socio-economic deprivation. Significant association between the relatively high T2DM mortality and the highest level of deprivation could also be detected, but less-deprived regions with high T2DM mortality and low metformin utilization could also be identified. Although the statistical associations detected in this ecological study do not indicate a causal relationship, it is reasonable to suppose that the underuse of metformin medication may contribute to the unfavourable T2DM mortality in certain regions. Our findings underline the need for more effective preventive services including metformin medication to decrease T2DM morbidity and mortality burden.

Keywords: socioeconomic status; metformin; redemption rate; preventive medication (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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