Trends in sodium‐glucose co‐transporter‐2 inhibitor prescribing at an Australian metropolitan hospital, 2014–2024

Sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors are established in optimising glycaemic control in people with type 2 diabetes mellitus (T2DM), with recent studies highlighting additional cardiorenal benefits irrespective of diabetes status. Literature describing prescribing patterns of SGLT2 inhibitors in different settings within evolving indications is limited. We therefore identified Australian national and local hospital discharge prescribing trends for SGLT2 inhibitors among approved indications: T2DM, heart failure (HF), and chronic kidney disease (CKD). Prescribing data for SGLT2 inhibitors empagliflozin and dapagliflozin between January 2014–March 2024 were obtained from tertiary metropolitan hospital pharmacy records and the Pharmaceutical Benefits Scheme (PBS). Data were sorted utilising PBS prescribing codes for approved indications, adjusted for prevalence per 1000 people with each diagnosis, and joinpoint regression used to identify changes in trends described as average annual percentage change (AAPC). National SGLT2 inhibitor prescribing increased overall, particularly prior to 2017; the AAPC was 109% between 2015–2017, and 22% between 2018–2023, p < 0.05. T2DM‐related prescribing followed similar trends, and HF‐related and CKD‐related prescribing increased from 2022 when approved PBS indications were introduced, without impacting statistical trends. Hospital discharge prescribing, comparatively, was mostly stagnant (AAPC was 36% between 2015–2023, p < 0.05) before a notable increase following the first HF‐approved indication in 2022. CKD‐related prescribing remained limited. While SGLT2 inhibitor prescribing in both settings increased over the past decade, particularly in HF‐related prescribing by hospital clinicians, it likely remains underutilised. Additional research to further characterise this prescribing gap is needed to ensure those with approved indications can receive the metabolic and cardiorenal benefits of this medication class. Ethical approval was granted by the St Vincent's Hospital Human Research Ethics Committee Research (Reference no: 24033) and the study conforms to Australian National Statement on Ethical Conduct in Human Research .