Pharmacoeconomic study of oral hypoglycemic agents and insulin in type 2 diabetes mellitus

Abstract

Background:

Diabetes mellitus is a chronic, progressive disorder that requires conscientious management to avert complications. The prevalence of diabetes mellitus in India is 77 million, which is scattered across socioeconomic strata. Several combinations of OHA and insulin are employed in type 2 diabetes mellitus to maintain euglycemia.

Objective:

To estimate the cost and effectiveness of anti-diabetic medication in type 2 diabetes mellitus (T2DM).

Methodology:

An observational study was conducted among T2DM patients. Patients on combination therapy with anti-diabetic medication were identified, and patient demographics, medical and medication history, glycemic levels, and the cost of anti-diabetic medication were recorded. The data was obtained through a patient interview, a medication chart, and medication bills.

Results:

Among the 209 included participants, the mean age was 58.6 ± 10.53, and the mean duration of diabetes was 10.33 ± 6.17. The cost per prescription of metformin with glimepiride, dapagliflozin, and vildagliptin was ₹17, ₹38.83 and ₹42.93, respectively. Regular insulin was cost-effective in combination with OHA. The mean cost of antidiabetic medication for those with 16–20 and 21–25 years of diabetes was ₹141.88 and ₹304.57 respectively.

Discussion:

The combination of metformin and glimepiride was found to be cost-effective in maintaining blood glucose levels within the limit. Dual therapy with metformin and vildagliptin confers the same effect as with glimepiride but at an incremental cost. Higher costs lead to out-of-pocket expenditure, which influences patient adherence.

Conclusion:

Long-term medication consumption contributes to the economic burden on patients and the public. Effective and cost-saving choices reduce patients’ medication expenses and improve patient outcomes.