Cost-effectiveness analysis of metformin-based combination therapy in type 2 diabetes mellitus inadequately controlled with metformin

This research aims to analyze the cost-effectiveness of type 2 diabetes millitus (T2DM) therapy regimens based on metformin-dual therapy. This was a retrospective cohort study using medical records and billing data from T2DM patients. Study samples were chosen using consecutive sampling, including those aged 18 or older with type 2 diabetes with metformin combined with sulfonylurea, acarbose, or dipeptidyl peptidase-4 inhibitor (DPP4i); those with incomplete medical or financial records were excluded. The incremental cost-effective ratio (ICER) analysis showed that the metformin–sulfonylurea regimen was dominant, offering lower costs and greater effectiveness. Meanwhile, metformin–DPP4i demonstrated higher effectiveness than metformin–acarbose (ICER: IDR. 24,055,460 per unit increase in the proportion of controlled patients) and may serve as a therapeutic alternative.