Increasing Prescription of SGLT2 Inhibitors with Expanded Indications to the Elderly Population in Japan.

Abstract

Introduction: Indications for sodium-glucose cotransporter-2 (SGLT2) inhibitors have expanded to include heart failure and chronic kidney disease after the year 2020. Whether and how the demographic trends in the prescription of SGLT2 inhibitors have changed after the expansion of indications have not been studied extensively.

Methods: This study is a descriptive analysis of serial, cross-sectional data on nationwide prescription of SGLT2 inhibitors between April 2016 and March 2023 obtained from NDB Open Data Japan, which contains more than 95% of total health insurance reimbursement claims in the nation.

Results: The total number of SGLT2 inhibitor tablets prescribed in outpatient settings with prescriptions papers increased from 577,996,158 tablets in fiscal year (FY) 2020 to 904,598,175 tablets in FY 2022. Patients aged 75 years and older accounted for 20.3% of the total prescriptions in FY 2020, and this proportion increased to 27.8% in FY 2022. Among all SGLT2 inhibitors, the tablet that expanded its indications for patients with heart failure and chronic kidney disease the earliest showed the largest percentage increase in the number of prescribed tablets during this period and the highest share of the elderly population in its recipients in both sexes (men, 35.9%; women, 49.4%) in FY 2022. The number of prescribed SGLT2 inhibitor tablets per population was constantly higher in men than in women between FY 2020 and 2022, which is consistent with the sex difference in the prevalence of these diseases.

Conclusion: Prescription of SGLT2 inhibitors to the elderly population is no longer infrequent and accounts for a large portion of the entire prescription of SGLT2 inhibitors in Japan. These findings contribute to updating our perception on the demographics of SGLT2 inhibitor recipients.