Cost-Minimization Analysis of Metformin and Acarbose in Treatment of Type 2 Diabetes

Abstract Background Metformin is the first-line oral hypoglycemic agent for type 2 diabetes mellitus (T2DM) per international guidelines with proven efficacy, safety, and cost-effectiveness. However, little information comparing it with acarbose exists. Objective To study the cost-effectiveness of metformin and acarbose—two extensively adopted agents—in treating T2DM. Methods Cost-minimization analysis was conducted on the assumption that metformin and acarbose have equivalent clinical effectiveness. The cost of treatment was detected and evaluated from a payer's perspective. In sensitivity analyses, several clinical scenarios were developed according to clinical practices and physicians' prescribing behaviors in China. Results Metformin can save annual treatment costs by 39.87% to 40.97% compared with acarbose. Under a wide range of assumptions on utilization profile and physician prescribing behavior, it saves costs by 19.83% to 40.97% in patients whose weight is 60 kg or less and by 39.87% to 70.49% in patients whose weight is more than 60 kg, which corroborates the results that metformin is more cost-effective than acarbose. Conclusions Metformin appears to provide better value for money than does acarbose. Findings from this study are consistent with those from previous studies that metformin is undoubtedly the first choice in the management of T2DM, with significant glucose-lowering effects and low treatment costs.