Cost-effectiveness analysis of metformin-glimepiride vs metformin-vildagliptin on glycemic control in type 2 diabetes patients at RSUD dr. Soekardjo

Wahyu Permana; Nur Rahayuningsih; Rahmawati Rahmawati

doi:10.35814/jifi.v24i2.2132

Authors

Wahyu Permana Department of Pharmacy, Faculty of Pharmacy, Universitas Bakti Tunas Husada, Tasikmalaya, 46115, Indonesia
Nur Rahayuningsih Department of Pharmacy, Faculty of Pharmacy, Universitas Bakti Tunas Husada, Tasikmalaya, 46115, Indonesia
Rahmawati Rahmawati Department of Pharmacy, Faculty of Pharmacy, Universitas Bakti Tunas Husada, Tasikmalaya, 46115, Indonesia

DOI:

https://doi.org/10.35814/jifi.v24i2.2132

Keywords:

Cost-effectiveness analysis, direct medical costs, glycemic control, metformin combination, T2DM

Abstract

Type 2 Diabetes Mellitus is a major public health problem that substantially contributes to the long-term healthcare cost burden. Combination therapy is often required to achieve optimal glycemic control; however, economic considerations are important in selecting an appropriate therapeutic regimen. This study aimed to analyze the cost-effectiveness of metformin–glimepiride (M-G) compared with metformin-vildagliptin (M-V) combination therapy in achieving glycemic control among outpatients with T2DM at a regional public hospital in Indonesia. A retrospective observational study with a cost-effectiveness analysis approach was conducted from January to April 2026 using medical record data from 2025. A total of 32 eligible patients were enrolled in the study, including 24 patients who received the M-G regimen and 8 patients who received the M-V regimen. Direct medical costs were estimated from the provider perspective using hospital medical and financial records and included costs associated with medications, physician consultations, laboratory examinations, and hospital services. Effectiveness was measured based on the percentage reduction in random plasma glucose levels. The results showed that the M-V combination demonstrated higher effectiveness (62.5%) compared with M-G (50%), with a difference of 12.5%. However, the average direct medical cost in the M-V group was higher (IDR 370.659) than in the M-G group (IDR 244,589). The average cost-effectiveness ratio (ACER) was lower in the M-G group (IDR 4,891.78) compared with the M-V group (IDR 5,930.54). The incremental cost-effectiveness ratio (ICER) indicated that each additional 1% increase in effectiveness with M-V required an additional cost of IDR 10,085.60. Therefore, based on effectiveness outcomes, the M-V combination was considered more cost-effective.

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