Antoaneta TsvetkovaMedical University – Varna, Bulgaria
Title: New approaches in the treatment of type 2 diabetes - transition from glucose-centred to patient-centred model
The high prevalence of Type 2 diabetes mellitus (T2D) all over the world cause a high demand of searching for new antidiabetic drugs. The present study aims to identify the consumption of three new classes of antidiabetic drugs (DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors), analyzing the use of these drugs prescribed for the treatment of T2D. In this retrospective observational study, we analyzed consumption data for the period 2015–2020, obtained from National Health Insurance Fund (NHIF) database only. The NHIF expenditure of DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors in Bulgaria for the period 2015-2020 is increasing. The concept of “precision medicine” of the P4 Medicine approach (Predictive, Preventive, Personalized & Participatory) outlines new guidelines for the choice of T2D treatment. The management of T2D is a complex one, where the choice of treatment is patient-centred and focused on the patient’s needs and comorbidities. The treatment objectives are the optimization of glycaemic control along with body weight reduction, as well as management of microvascular or macrovascular complications, and lifestyle changes leading to an improvement in “quality of life”. The choice of pharmacotherapy needs to consider the presence of risk factors: risk of hypoglycaemia, cardiovascular disease (CVD), heart failure (HF), chronic kidney disease (CKD), contraindications and price. Although last introduced into clinical practice, SGLT-2 inhibitors were preferred by clinicians, over GLP-1 agonists, during the considered period.
Prof. Antoaneta Tsvetkova has completed her Master's degree in "Health Technology Assessment with Pharmacoeconomics", Professional Direction of Pharmacy, Faculty of Pharmacy of Medical University – Sofia, Bulgaria. She is Master of Health Management, Medical University – Varna, Bulgaria. She is the director of Medical College, Medical University "Prof. Dr. Paraskev Stoyanov" – Varna, Bulgaria. Her main professional and scientific interests lie in the fields of pharmacoeconomics, health technology assessment, pharmaceutical marketing, public health. She is a member of: WHO European Regions for Health Network (RHN), BSSPH (Bulgarian Scientific Society of Public Health), Bulgarian Society for Pharmacoeconomics (ISPOR Bulgaria Chapter), Bulgarian Society of Obstructive Sleep Apnea and Snoring, Bulgarian Academy of Sleep Medicine, working committees on health technology assessment at the National Center for Public Health and Analysis (NCPHA), the General Meeting of the Shareholders of MHAT "St. Anna – Varna" AD as a representative of the Municipality of Varna, Standing and Temporary Committees – Standing Committee (SC) on Healthcare, SC Science and Education, Temporary Committee on Protection and Reproduction of the Environment at the Municipal Council of Varna, the Advisory Council for HIV/AIDS Prevention. She has more than 80 publications in scientific journals and collections of Bulgarian and international conferences. Co-author of three textbooks related to her teaching activities.