Cost-effectiveness Analysis of Oral Hypoglycemic Drugs for the Treatment of Type-II Diabetes Mellitus in a Tertiary Care Setup Karachi

摘要

The aim of the study was to analyze the current prescription pattern and compare the cost-effectiveness parameter of oral monotherapy and combination hypoglycemic drugs among type-II diabetes mellitus. A cross sectional study was conducted in a tertiary care hospital of Karachi Pakistan for a period of six months. A total of 377 diabetic type II patients were enrolled via purposive sampling method. Detailed sheets were prepared based on objectives of study for analysis of prescription and cost effective therapy. Out of total 377 enrolled type-II diabetes mellitus 70.8% (n=267and 29.2% (n=110) were females with mean age of 36.16±11.15, the prescription status showed that 18.30% (n=69) received monotherapy and 57.30% (n=216) of dual drug therapy and 24.40% (n=92) of triple therapy among combination therapy of oral antidiabetic drugs. The effectiveness of treatment is considered for the treatment obtaining lesser values for ICER hence the value of ICER among mono drug therapies for Glibenclamide 5mg was -720, with baseline value for HbA1C 7.6±0.99, and effectiveness of 0.5, with %E of 0.8.For glimepiride 2mg the ICER was calculated as -2160, with baseline of 7.2±1.5, IE -0.5and ?E 0.3 of from class alpha glucose inhibitor for voglibose 0.3mg ICER was obtained-800, with baseline HbA1C of 7.5±2.1, IE 0.1, and ?E 0.5% as shown in below table 4. The ICER for the add on therapy of Glibenclamide 2.5mg+Metforming 500mg with baseline value of 8.1±2.1 with ?E of 0.3%, and incremental cost (IC) of -10087.2 was obtained 0. ICER was also 0 for sitagliptin 50mg +metformin 500mg with baseline 7.8±0.5, ?E 0.6% and IE value of 0. ICER value of sitagliptin 50mg +metformin 850mg was obtained -648 with ?E 0.1%, IE value -0.5. An ICER value of -2676 was obtained for metformin 850mg +pioglitazone 15mg with baseline of 7.6±1.7 and ?E of 0.4% and IE of this therapy was 0.3. The outcome of drug utilization studies evaluates the current prescribing pattern of oral hypoglycemic agents and concomitant drugs with respect to the clinical efficacy of hypoglycemic drugs.