Cost-effectiveness analysis of sitagliptin and pioglitazone in poorly controlled type 2 diabetes mellitus patients with oral metformin

Objective To compare cost-effectiveness and short-term clinical outcome of sitagliptin and pioglitazone in poorly controlled type 2 diabetes mellitus (T2DM) patients with oral metformin. Methods The clinical data of 152 T2DM patients were retrospectively analyzed. The efficacy and cost-effectiveness was compared between oral metformin combined with sitagliptin and pioglitazone for the treatment of T2DM. Results Compared with baseline, the body weight of the patients treated with metformin plus pioglitazone was significantly increased (P0.05), whereas it was significantly decreased in the patients with metformin plus sitagliptin (P0.05). Fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were significantly reduced in all patients after treatment (P0.05). The body weight of the patients with metformin plus sitagliptin was significantly lower than that of the patients treated with metformin plus pioglitazone after treatment (P0.05). There were no significant differences in total effective rates (FPG and HbA1c control) or incidence rates of adverse effect between the two groups (all P0.05).The total cost was 2 064.3 yuan in the pioglitazone group and 1 577.1 yuan in the sitagliptin group. Cost-effectiveness analysis showed that in the control of FPG the ratio of cost to effectiveness (C/E) was 25.0 and 21.0 in the pioglitazone group and sitagliptin group, respectively (△C/△E was 65.0); C/E in the control of HbA1c was 22.9 and 18.9 in the two groups, respectively (△C/△E was 72.7). Sensitivity test showed that the total cost was 1 930.5 yuan and 1 492.1 yuan in the pioglitazone group and sitagliptin group after adjustment; C/E in the control of FPG was 23.4 and 22.7 in the two groups (△C/△E was58.5); C/E in the control of HbA1c was 21.5 and 17.9 (△C/△E was 65.4). Conclusion Additional use of sitagliptin in poorly controlled T2DM patients with oral metformin is more efficient in pharmacoeconomic cost-effectiveness analysis. It is an appropriate therapy to treat T2DM.