ArticleBMC health services research2020
Impact of co-payment level increase of antidiabetic medications on glycaemic control: an interrupted time-series study among Finnish patients with type 2 diabetes.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05291026 (Evaluation of mHealth Intervention to Improve Medication Adherence in Type 2 Diabetes in Nigeria), which is not on this map. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Evaluation of mHealth Intervention to Improve Medication Adherence in Type 2 Diabetes in Nigeria: a Randomized Controlled Trial
Who cites it
9 citing papers in PubMed, 34 citations in OpenAlex.
- Time Trends of Body Mass Index and its Impact on Glycemic Control Among Finnish Patients with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Article
- Trends in global glucose lowering medication consumption: Insights from pharmaceutical sales data (2010-2021).PLOS global public health · 2025Article
- Second-line pharmacotherapy intensification after metformin monotherapy in type 2 diabetes: a nationwide register study from Finland during 2011-2022.BMC health services research · 2024Article
- Drawing up the public national Rational Pharmacotherapy Action Plan as part of social and health services reform in Finland: a bottom-up approach involving stakeholders.BMC health services research · 2024Article
- Austerity, economic hardship and access to medications: a repeated cross-sectional population survey study, 2013-2020.Journal of epidemiology and community health · 2023Article
- Socioeconomic inequalities in insulin initiation among individuals with type 2 diabetes - A quasi-experimental nationwide register study.SSM - population health · 2022Article
- Type 2 diabetes medication and HbA1c levels in North Karelia Finland, 2013-2019.Diabetic medicine : a journal of the British Diabetic Association · 2022Article
- Citizens' opinions and experiences related to costs and reimbursements for medications in times of retrenchment: cross-sectional population surveys in 2015 and 2017.International journal for equity in health · 2022Article
- The effect of pharmaceutical co-payment increase on the use of social assistance-A natural experiment study.PloS one · 2021Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundA new special reimbursement scheme (SRS) for non-insulin medications used for treatment of hyperglycaemia in type 2 diabetes (T2D) was implemented in Finland on January 1, 2017. The new SRS affected all community-dwelling Finnish T2D patients as all community-dwelling residents are eligible for reimbursement for prescription medications. The aim of the study was to evaluate the impact of this co-payment increase on glycaemic control among Finnish T2D patients.
methodsData on glycaemic control were collected with HbA1c measures from electronic health records from primary health care and specialized care in the North Karelia region, Finland, from patients with a confirmed T2D diagnosis in 2012 who were alive on January 1, 2017 (n = 8436). Average HbA1c levels were measured monthly 36 months before and 33 months after the policy change. Consumption of diabetes medications was measured with defined daily doses (DDDs) based on reimbursed medication purchases. Interrupted time series design analysed with segmented regression model was applied to examine the effect of the policy change on average HbA1c levels.
resultsEight thousand one hundred forty-three T2D patients had at least one HbA1c measurement within 01/2014-9/2019. Mean age of the patients was 68.1 (SD 11.3) years and 53.0% were women. Average time since T2D diagnosis was 11.5 (SD 6.1) years. An estimated increase of 0.81 (95% confidence interval, CI, 0.04-1.58) mmol/mol in average HbA1c levels was detected at the time of the policy change. In subgroup analyses, strongest effects were detected among patients who used only other diabetes medications than insulin or metformin in 2016 (3.56 mmol/mol, 95% CI 2.50-4.62). Meanwhile, yearly consumption of diabetes medications decreased slightly from 618.9 (SD 487.8) DDDs/patient in 2016 to 602.9 (SD 475.6) DDDs/patient in 2017 (p = 0.048).
conclusionsSimultaneously with the increase of the co-payment level, the average HbA1c level increased among T2D patients from the North Karelia region, Finland. This may be explained by the decreased consumption of diabetes medications between 2016 and 2017. Special attention should be allocated to glycaemic control of patients utilizing only other antidiabetic medications than metformin or insulin.
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