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 Type 2 Diabetes Mellitus (T2DM) represents a major public health challenge that substantially contributes to long-term healthcare expenditure. Although combination therapy is frequently required to achieve optimal glycemic control, economic considerations play a critical role in selecting appropriate therapeutic regimens. This study aimed to evaluate the cost-effectiveness of metformin–glimepiride (M-G) versus metformin–vildagliptin (M-V) combination therapy in achieving glycemic control among outpatients with T2DM at RSUD dr. Soekardjo, Tasikmalaya. A retrospective observational study employing a cost-effectiveness analysis approach was conducted using medical record data from January to December 2025, involving a total of 32 eligible patients (24 in the M-G group and 8 in the M-V group). Direct medical costs were estimated from the hospital provider perspective, whereas treatment effectiveness was measured by the percentage reduction in random plasma glucose (RPG) levels. The results demonstrated that the M-V combination yielded a higher clinical effectiveness (62.5%) compared to the M-G combination (50%). However, the average direct medical cost was higher in the M-V group (IDR 370,659) than in the M-G group (IDR 244,589). The Average Cost-Effectiveness Ratio (ACER) was lower for the M-G regimen (IDR 4,891.78) than for the M-V regimen (IDR 5,930.54). Furthermore, the Incremental Cost-Effectiveness Ratio (ICER) indicated that each additional 1% improvement in effectiveness achieved with M-V required an additional cost of IDR 10,085.60. Consequently, the M-V combination was considered more cost-effective based on its clinical effectiveness outcomes.

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