Cost-effectiveness analysis of oral anti-diabetic medications: DPP-4 inhibitor as monotherapy vs. combination therapy in type 2 diabetic patients in Malang, Indonesia

Oktaviana, Prita Aldilla and Triastuti, Efta and Yurina, Valentina and Che Hasan, Muhammad Kamil and Sidek Ahmad, Zulkhairul Naim (2025) Cost-effectiveness analysis of oral anti-diabetic medications: DPP-4 inhibitor as monotherapy vs. combination therapy in type 2 diabetic patients in Malang, Indonesia. Malaysian Journal of Medicine and Health Sciences, 21 (Supp 6). pp. 202-206. ISSN 1675-8544 E-ISSN 2636-9346

Preview	PDF (Contents) Download (85kB) | Preview
	PDF - Published Version Restricted to Repository staff only Download (158kB) | Request a copy

Abstract

Background: Several anti-diabetic medications are covered under the Indonesian Universal Health Coverage (BPJS). However, metformin is typically prioritized over other options, such as DPP-4 inhibitors, because they are considered costly. DPP-4 inhibitors are often prescribed as an alternative to metformin when patients experience side effects, such as gastrointestinal discomfort and weight gain. This study aims to assess the cost-effectiveness of DPP-4 inhibitors in treating type 2 diabetic patients both as monotherapy and in combination with other oral anti-diabetic medications. Methods: Data were retrospectively collected from the medical records of diabetic patients treated at a hospital in Malang, Indonesia, known for prescribing DPP-4 inhibitors. A total of 87 medical records of ambulatory patients over 18 years old who had received DPP-4 inhibitors for at least three months were selected for analysis. Cost-effectiveness was assessed by calculating the average cost-effectiveness ratio (ACER). Results: The analysis revealed that the combination of DPP-4 inhibitor and metformin yielded the lowest ACER values for HbA1c (IDR 3,633) and fasting blood glucose (FBG) (IDR 3,230). In contrast, DPP-4 inhibitor monotherapy yielded the lowest ACER value for postprandial blood glucose (PPBG) (IDR 2,891). Additionally, the combination of DPP-4 inhibitor, metformin, and sulfonylurea yielded the lowest ACER values for reducing HbA1c (IDR 171,573), FBG (3,871), and PPBG (IDR 3,185) levels. Conclusions: The combination of DPP-4 inhibitor, metformin, and sulfonylureas was the most cost-effective treatment for reducing HbA1c, FBG, and PPBG levels. The combination of DPP-4 inhibitor and metformin and DPP-4 inhibitor monotherapy also showed competitive cost-effectiveness in achieving therapeutic targets.

Item Type:	Article (Journal)
Uncontrolled Keywords:	ACER, cost-effectiveness, DPP-4 inhibitor, ICER, type 2 diabetes mellitus
Subjects:	R Medicine > RT Nursing R Medicine > RT Nursing > RT89 Specialities in nursing R Medicine > RT Nursing > RT89 Specialities in nursing > RT90.7 Primary nursing
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Nursing > Department of Medical Surgical Nursing Kulliyyah of Nursing
Depositing User:	Dr Muhammad Kamil Che Hasan
Date Deposited:	11 Aug 2025 09:27
Last Modified:	11 Aug 2025 09:27
URI:	http://irep.iium.edu.my/id/eprint/122525

Actions (login required)

View Item