Diabetes in Indonesia: What Medicines do Physicians Prefer?

As concerns mount about Indonesia’s growing diabetes epidemic, many organizations are working to increase awareness and improve treatment of the disease. Yet good data on the burden of diabetes and patient treatment pathways remains limited. mClinica has several datasets that can help.
One such dataset is based on a longitudinal sample of prescription information that we collected from a panel of pharmacies in Jakarta over the past year. These prescriptions contain a rich trove of information about how diabetes and other conditions are being identified and treated in the private healthcare market. They shed light on epidemiological trends and prescribing habits in Indonesia’s largest and most important city.
To gain an initial look at the state of diabetes treatment in Jakarta, we recently pulled data from the first quarter of 2016. As one might expect, the data shows that older OADs are more commonly prescribed than any other kind of diabetes medicine. Classic therapies like metformin and suphonylurea (SU) medicines are typically preferred because they are proven to be effective and relatively inexpensive.

For most older therapies, physicians in Jakarta tend to prescribe generics. In our sample, generic metformin and glimepiride accounted for over a quarter of all prescriptions. Branded medicines by Merck and Sanofi still had strong prescription share, but this may erode over time.

Compared to older therapies, newer therapies in the gliptin segment have smaller share of the total prescription pie. Since these therapies tend to be more expensive, however, they likely account for a significant share of total spending on diabetes medicines. In our sample, MSD’s two gliptin medicines had greater combined share than any other manufacturer in the category.

MSD also leads the gliptin segment in Vietnam, another country where we’ve analyzed prescription trends for diabetes medicines. In an April 2016 study on diabetes in Ho Chi Minh City, we found that Janumet had the highest prescription share and the fastest rate of growth in the category. Across the category, gliptin + metformin combination therapies gained share at the expense of monotherapies in HCMC. Further analysis is needed to know if similar trends are unfolding in Jakarta.
Vietnam is an important market for diabetes manufacturers because it has Southeast Asia’s fastest-growing diabetic patient population, yet Indonesia’s total diabetic patient population is much bigger. Indonesia had over 10 million diabetics in 2015, according to data from the International Diabetes Federation. The Philippines and Vietnam, by contrast, both had approximately 3.5 million diabetics that same year (though some pharmaceutical companies believe that to be an underestimate). In all three countries, more than half of all patients are undiagnosed.
With so many diabetics across the region, disease awareness and management programs will be increasingly essential to improve health outcomes and reduce costs on an already-overburdened healthcare system. mClinica’s proprietary datasets and technology platforms can help organizations assess the scale of the problem, develop data-driven interventions, and measure health outcomes. If you are a healthcare organization with an interest in tackling this problem, please contact us.