Healthcare costs of the combination of metformin/dipeptidyl peptidase-4 inhibitors compared with metformin/other oral antidiabetes agents in patients with type 2 diabetes and metabolic syndrome.

Abstract

OBJECTIVES:

This study assessed the health costs resulting from the combination of metformin/dipeptidyl peptidase-4 (DPP-4) inhibitors compared with metformin/oral antidiabetes drugs in patients with type 2 diabetes and metabolic syndrome (MS).

PATIENTS AND METHODS:

An observational retrospective study was performed. Patients ≥30 years of age who were receiving treatment with metformin who started a second oral antidiabetes therapy in 2008 and 2009 were included. Patients were divided into two groups: (a) metformin plus DPP-4 inhibitors and (b) metformin plus other oral antidiabetes drugs. The main measures were compliance, persistence, metabolic control (glycosylated hemoglobin level of <7%), and complications (hypoglycemia and cardiovascular events). Healthcare and non-healthcare costs were calculated. Patients were followed up for 2 years. An analysis of covariance was carried out (P<0.05 was considered significant).

RESULTS:

Of the 1,435 patients (mean age, 67.3 years; 53.1% male) who were enrolled, 442 (30.8%) were receiving metformin plus DPP-4 inhibitors, and 993 (69.2%) were receiving metformin plus other oral antidiabetes drugs. The prevalence of MS was 72.2% (95% confidence interval, 71.1-73.3%). Patients treated with DPP-4 inhibitors had better compliance (69.1% vs. 63.8%), persistence (63.8% vs. 53.1%), and metabolic control (69.9% vs. 64.3%) (P<0.01) compared with those receiving other antidiabetes drugs, lower rates of hypoglycemia (14.3% vs. 41.1%) and cardiovascular events (2.9% vs. 5.7%) (P<0.01), and a lower mean adjusted unit cost (€2,278 vs. €2,631; P=0.003).

CONCLUSIONS:

Despite the limitations of this observational study, diabetes patients with MS who were treated with metformin plus DPP-4 inhibitors had better compliance, greater metabolic control, and lower rates of hypoglycemia, causing lower costs for the Spanish national health system than patients receiving metformin plus other antidiabetes drugs.

• Authors: Antoni Sicras-Mainar, Ruth Navarro-Artieda
• Journal: Diabetes technology & therapeutics (Diabetes Technol Ther) Vol. 16 Issue 11 Pg. 722-7 (Nov 2014) ISSN: 1557-8593 [Electronic] United States
• PMID: 25089916 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Dipeptidyl-Peptidase IV Inhibitors
• Glycated Hemoglobin A
• Hypoglycemic Agents
• hemoglobin A1c protein, human
• Metformin

Topics

• Aged
• Blood Glucose (drug effects)
• Cardiovascular Diseases (economics, epidemiology, prevention & control)
• Cost-Benefit Analysis
• Diabetes Mellitus, Type 2 (drug therapy, economics, epidemiology)
• Diabetic Angiopathies (economics, epidemiology, prevention & control)
• Dipeptidyl-Peptidase IV Inhibitors (administration & dosage, economics)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Glycated Hemoglobin (drug effects)
• Health Care Costs
• Humans
• Hypoglycemia (prevention & control)
• Hypoglycemic Agents (administration & dosage, economics)
• Male
• Medication Adherence
• Metabolic Syndrome (drug therapy, economics, epidemiology)
• Metformin (administration & dosage, economics)
• Retrospective Studies
• Spain (epidemiology)
• Treatment Outcome