ESPE Abstracts

Background: Metformin is the only oral antihyperglycaemic agent (AHA) approved for use in youths with type 2 diabetes mellitus (T2DM). It may also be used to treat other conditions such as hyperinsulinaemia, pre-diabetes, and polycystic ovarian syndrome (PCOS). Therefore, an assessment of the prevalence of T2DM in the paediatric population based on the utilisations for metformin may overestimate the burden of the disease. However, metformin utilisation patterns in youths remain unclear.

Objective and hypotheses: To assess metformin utilization patterns in paediatric patients in the US from 2009 through 2013.

Method: We used annual data from the National Disease and Therapeutic Index (NDTI), an ongoing office-based physician survey conducted by IMS Health (Plymouth Meeting, Pennsylvania) that provides national level estimates of disease and treatment patterns occurring in physician offices. Drug use frequency and therapeutic indications of single-ingredient metformin for paediatric patients 10–19 years of age between 2009 and 2013 were extracted and analysed. Descriptive statistical analysis was used to examine changes in the number of and reasons for metformin use over the 5-year period.

Results: Metformin use by physicians for youths has decreased by 42.8% from 2009 to 2013 (from 217 716 in 2009 to 124 386 in 2013). The most common therapeutic indication metformin was used was diabetes (34.9%), followed by metabolic syndrome (25.5%), PCOS (17.2%), and obesity (6.5%). Metformin utilisation pattern remained stable between 2009 and 2013.

Conclusion: Diabetes only accounted for approximately a third of the total metformin use in paediatric population aged 10–19 years. Other indications included metabolic syndrome, PCOS and obesity. Despite the NDTI’s limitations arising from sampling and data collection methodologies, our study provides useful insights into metformin utilization patterns among paediatric population and suggests that caution should be exercised when utilising metformin prescription as a proxy to estimate the burden of T2DM in youths.

Conflict of interest: All authors are employees of Merck & Co., Inc., Kenilworth, NJ.

Funding: This study was funded by Merck & Co., Inc., Kenilworth, NJ.