- January 22, 2025
Poland is the only country in the European Union that does not reimburse incremental drugs. The monthly cost of therapy with new-generation drugs may reach even several hundred zlotys, so patients rarely agree to such treatment.
- According to the World Health Federation, the number of patients with diabetes in Poland is estimated at about 3 million, mainly type 2 diabetes. Unfortunately, the number of patients is constantly increasing. It should be assumed that in the following years, despite the decreasing number of people, the number of diabetes patients will grow in absolute values - says Prof. Władysław Grzeszczak, head of the Department of Internal Medicine, Diabetology and Nephrology of the Silesian Medical University in Katowice, in an interview with the Newseria information agency.
According to the International Diabetes Federation, Poland ranks 4th in Europe in terms of the prevalence of diabetes mellitus. 90% of patients have type 2 diabetes mellitus, mainly due to obesity, sedentary lifestyle and poor nutrition. According to experts, the number of patients will continue to grow in the coming years. Poland is one of the last countries in the European Union in terms of expenditure on treatment of one diabetic. Metformine and drugs from the group of sulfonylureaemia are used in the treatment of this disease.
- Sulphonylurea is not a bad medicine. However, they have been on sale since the 1950s. Today, newer drugs should be used, such as DPP-IV blockers or GLP-1 analogues, i.e. incremental drugs, which reduce the risk of hypoglycaemia incidents and reduce body weight in patients - says Prof. Grzeszczak.
Incremental drugs increase insulin secretion by the pancreas, slow down gastric emptying and inhibit appetite. During their use there is no weight gain, which is very important in the treatment of diabetes. They do not cause hypoglycaemia, i.e. incidents of excessive lowering of blood sugar levels, which can lead to serious complications.
These drugs have been available on the market for nearly 10 years, however, in Poland they are rarely used in diabetes therapy due to their high cost.
- Patients and diabetologists have been calling for their reimbursement for a long time, so far it has not been implemented by the regulator. We have the impression that for some patients the appearance of incremental drugs would be very important, because they are expensive drugs. Greater availability of these medicines would improve the quality of care and treatment. The patient would not have hypoglycaemia and acute and chronic complications - says Michał Sutkowski, a family medicine specialist, president of Warsaw General Practitioners, spokesman for the College of General Practitioners in Poland.
According to experts, the introduction of reimbursement of incremental medicines would in the future reduce the indirect costs to the State for the treatment of diabetes. All the more so as the most frequent complications of diabetes are problems with heart, kidneys and eyesight. In addition to the direct costs of treatment, the costs also include indirect costs related to the loss of productivity of the sick, permanent inability to work and pensions. In Finland, where incremental medicines have been reimbursed for nearly four years, the number of hospitalisations has been significantly reduced, and thus the state budget expenditure on these medicines has decreased. In this way, the costs of treatment with these drugs have been balanced.
In Poland, a major problem is also the difficult access to specialist doctors: nephrologists, ophthalmologists, cardiologists and neurologists, as well as diabetes clinics.
- The new issue with the queuing package is that there is no 3.0 indicator for diabetes and cardiovascular disease patients. This means that there are fewer resources for diabetic patients, for the family doctor in primary care. Instead of 3x96 PLN per year, we have a unified rate of 140 PLN per year. That is, in theory, there are fewer resources for such patients, which, of course, does not mean that they are to be treated less well by us. These patients require constant and good care both in terms of our workload and numerous additional examinations - says Michał Sutkowski.
