Trends in Inflation-Adjusted Pharmacotherapy Costs and Cardiovascular Risk Factor Management in Type 2 Diabetes: A 26-Year Study from Tertiary Diabetes Centres in Greece Drug Costs and Risk Factors in Type 2 Diabetes

Aims: We evaluated long-term trends in pharmacotherapy costs and cardiovascular target achievement among people with type 2 diabetes attending tertiary diabetes centres in Greece. Methods: This periodic, multicenter, cross-sectional study analysed data from 4,963 people with type 2 diabetes followed in each of the three diabetes centres at specific time points: 1998, 2006, 2012, 2018, and 2024. We compared HbA1c, systolic blood pressure, LDL-C, and BMI and the achievement of individual cardiovascular targets (HbA1c <7%, systolic blood pressure <140 mmHg, LDL-C <100 mg/dL) and all three simultaneously. Annual pharmacotherapy cost comparisons used inflation-adjusted values. Results: Simultaneous achievement of all three cardiovascular targets increased from 0.6% in 1998 to 29.1% in 2024. Individual target achievements improved: HbA1c from 29.4% to 58.6%, systolic blood pressure from 45.3% to 62.5%, and LDL-C from 6.3% to 73.4%. Mean LDL-C showed the greatest reduction, from 128.4 mg/dL to 79.0 mg/dL. Median BMI increased until 2018, then declined in 2024. Total pharmacotherapy costs per patient rose from €341 in 1998 to €1,609 in 2024, primarily due to glucose-lowering therapies (€167 to €1,257). Conclusion: Over 26 years, people with type 2 diabetes attending tertiary diabetes centres in Greece demonstrated improvements in cardiovascular target achievement, alongside rising pharmacotherapy costs, primarily driven by glucose-lowering therapies.