Glycemic control and cost-effectiveness attained by the drug utilization of oral antidiabetic agents in a tertiary care hospital in South India

Abstract

Background: Diabetes mellitus require lifelong intervention and Kerala has high prevalence. New expensive agents require comparison with existing regimens for cost-effectiveness.Methods: Socio-demographic, anthropometric, FPG and HbA1C (baseline and post treatment) of 150 patients (73 men; 77 women) were obtained from records using standard case report forms in our retrospective study. ANOVA and paired t test were used for between groups and within group comparison.Results: Metformin was maximum utilized (DDD/1000/day-252.39). All treatment regimens produced significant reduction in FPG (except metformin monotherapy) and HbA1C (except metformin sulfonylurea α-glucosidase inhibitor DPP-4 inhibitor combination). When compared to metformin sulfonylurea pioglitazone combination (best therapy), other regimens were less cost effective in reducing FPG and metformin sulfonylurea α-glucosidase inhibitor DPP-4 inhibitor was more effective and expensive in reducing HbA1C.Conclusions: High prescription rates of metformin were due to its action on insulin resistance and weight. Addition of pioglitazone was cost effective and DPP-4 inhibitor was expensive but effective.