Linda A. Cruz-Gallegos, Unidad de Medicina Familiar No. 9, Instituto Mexicano del Seguro Social (IMSS), Querétaro, Querétaro, México
Enrique Villarreal-Ríos, Unidad de Investigación Epidemiológica y en Servicios de Salud, IMSS, Querétaro, Querétaro, México
Leticia Blanco-Castillo, Unidad de Medicina Familiar No 11, IMSS, Querétaro, Querétaro, México
Liliana Galicia-Rodríguez, Unidad de Investigación Epidemiológica y en Servicios de Salud, IMSS, Querétaro, Querétaro, México
Background: And new high-cost antihyperglycemic agents have been introduced into the basic medical at primary care level for its management. The cost-effectiveness evaluation allows the economic and epidemiological components to be analysed together. Objective: To determine the cost-effectiveness of dual therapy with metformin + sitagliptin versus metformin + dapagliflozin in patients with type 2 diabetes. Material and methods: Economic cost-effectiveness study with two groups of patients with type 2 diabetes aged 30 to 64 years in dual treatment, metformin + sitagliptin versus metformin + dapagliflozin. The fixed and variable unit costs were examined; the average variable cost was estimated using the microcost technique, and the average fixed cost was estimated using the time and motion technique. The average annual cost was integrated with the average variable and fixed costs. The cost-effectiveness ratio was estimated at $4000 and cost-effectiveness projections were made. Results: Glycaemic control (efficacy) was 42.10% for metformin + dapagliflozin and 26.50% for metformin + sitagliptin. In the intermediate scenario, average annual costs were $3598.52 for metformin + dapagliflozin and $5,746.82 for metformin + sitagliptin. For an investment of $4000, the effectiveness of the metformin + dapagliflozin group was 46.80%, and the effectiveness of the metformin + sitagliptin group was 18.44%. Conclusions: In patients with type 2 diabetes, metformin + dapagliflozin achieves the best cost-effectiveness ratio.
Keywords: Metformin. Sitagliptin. Dapagliflozin. Cost-effectiveness. Glycemic control. Diabetes type 2.