Abstract

A RETROSPECTIVE OBSERVATIONAL STUDY ON PHARMACOECONOMIC ANALYSIS OF SULFONYLUREA AND DPP-4 INHIBITOR IN A COMBINATION WITH METFORMIN FOR THE TREATMENT OF TYPE 2 DIABETES MELLITUS: A COST-EFFECTIVENESS STUDY

Dr. Rahul Gupta, Mr. Ashwani Kumar, Dr. Shubham Singh Jat*, Dr. Mohit Khendelwal, Dr. Mohd Naved

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Abstract

Background: Many clinicians are taking the aggressive approach of adding a sulfonylurea or a dipeptidyl peptidase 4 (DPP 4) inhibitor to metformin as the initial therapy in type 2 diabetes mellitus. This is based on the available evidence that early combined oral drug therapies are more effective in lowering blood glucose levels than maximal doses of a single drug (T2DM). In an underdeveloped nation like India, pharmacotherapy for a chronic condition like diabetes has significant financial ramifications for individuals. As a result, it's critical to conduct a scientific evaluation of the cost-effectiveness of these regularly used combination medicines in the treatment of T2DM. Materials and Methods: This was a 6-month retrospective observational comparison research on T2DM patients who were given either metformin (500 mg) with glimepiride (2 mg) or metformin (500 mg) plus teneligliptin as a treatment (20 mg). Average the money expended on lowering HbA1c and lowering fasting plasma glucose (FPG) or random plasma glucose (RBS) levels after 6 months was calculated and compared for both groups in a cost effectiveness ratio study. The same was done to see whether there were any changes in BMI levels. Results: The cost effectiveness analysis showed that average cost (in rupees) of per unit reduction in HbA1c and FPG in metformin plus glimepiride group was significantly less than in the metformin plus teneligliptin. The average cost-effectiveness ratio for per unit reduction in FPG was highly significant in metformin plus glimepiride group though it was comparable for both the groups for per unit RBS reduction. Conclusion: When used as a short-term combination therapy in T2DM patients to reduce glycaemic parameters including HbA1c, RBS, and FPG, metformin plus glimepiride is a much more cost-effective therapy than metformin plus teneligliptin.

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