COST-EFFECTIVENESS ANALYSIS OF USING METFORMIN AND GLIMEPIRIDE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN YOGYAKARTA, INDONESIA

Abstract

Cost-effectiveness analysis (CEA) is a pharmacoeconomic method that assists in decision-making about the selection of benefit-effective and cost-effective therapies.  The average cost-effectiveness ratio (ACER) is expressed as the dollar amount generated for each specific clinical outcome, regardless of comparison.  The incremental cost-effectiveness ratio (ICER) reveals the costs to obtain one outcome unit relative to its comparison.  Metformin is an oral antidiabetic for people with type 2 diabetes mellitus.  Glimepiride can effectively improve glucose control in people with type 2 diabetes mellitus who possess a good health profile.  This research aimed to determine the effectiveness of therapy, average cost, and cost-effectiveness of using metformin and glimepiride in people with type 2 diabetes mellitus.  This research employed an observational study.  Data collection was carried out retrospectively using total sampling at the community health centers in Yogyakarta.  Data were analyzed using ACER or ICER to determine a more cost-effective therapy for lowering blood glucose levels.  The cost-effectiveness analysis involving a total of 192 patients, 133 patients receiving metformin and 59 patients receiving glimepiride, disclosed that glimepiride was more cost-effective than metformin.  The clinical results also unveiled the higher effectiveness of glimepiride therapy over metformin in reducing blood glucose levels.  The average cost of glimepiride was IDR 6,101, exhibiting an effectiveness of 77.96% and an ACER value of IDR 78.  The ICER calculation was omitted due to the low average cost, high effectiveness, and low ACER value of glimepiride in comparison to metformin.  Therefore, glimepiride demonstrated more cost-effectiveness than metformin in people with type 2 diabetes mellitus at the community health centers in Yogyakarta.