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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.
Diabetes Technol Ther. 2014 Nov; 16(11):722-7.DT

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+Show Affiliations

1 Management Planning, Badalona Healthcare Services SA , Badalona, Barcelona, Spain .No affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25089916

Citation

Sicras-Mainar, Antoni, and Ruth Navarro-Artieda. "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." Diabetes Technology & Therapeutics, vol. 16, no. 11, 2014, pp. 722-7.
Sicras-Mainar A, Navarro-Artieda R. 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. Diabetes Technol Ther. 2014;16(11):722-7.
Sicras-Mainar, A., & Navarro-Artieda, R. (2014). 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. Diabetes Technology & Therapeutics, 16(11), 722-7. https://doi.org/10.1089/dia.2014.0091
Sicras-Mainar A, Navarro-Artieda R. 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. Diabetes Technol Ther. 2014;16(11):722-7. PubMed PMID: 25089916.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Sicras-Mainar,Antoni, AU - Navarro-Artieda,Ruth, Y1 - 2014/08/04/ PY - 2014/8/5/entrez PY - 2014/8/5/pubmed PY - 2015/7/24/medline SP - 722 EP - 7 JF - Diabetes technology & therapeutics JO - Diabetes Technol Ther VL - 16 IS - 11 N2 - 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. SN - 1557-8593 UR - https://www.unboundmedicine.com/medline/citation/25089916/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_ L2 - https://www.liebertpub.com/doi/10.1089/dia.2014.0091?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -