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Introduction <p>Type&#xa0;2 diabetes (T2D) is a chronic metabolic disease that is highly prevalent in the United Arab Emirates (UAE). This study aimed to assess the cost-consequences of adding gliclazide modified release (MR) to metformin in patients with inadequate glycaemic control on metformin alone and of switching patients currently receiving a combination of sitagliptin and metformin to a combination of gliclazide MR and metformin.</p> Methods <p>We developed a cost-consequences decision-tree model comparing gliclazide MR and sitagliptin as second-line add-ons to metformin. Based on 2014–2023 Dubai Real World Claims Database data, the model estimated health outcomes (number of patients reaching HbA<sub>1c</sub> targets of &lt; 7% and ≤ 6.5% and cardiovascular [CV] events, i.e. myocardial infarction [MI] and hospitalisation for heart failure [HHF]), resource use (inpatient, emergency room, and outpatient visits, and hospital bed days), and costs (drug acquisition and medical costs) associated with the two therapies over a 1-year time horizon from the payer perspective.</p> Results <p>Adding gliclazide MR to metformin in a cohort of 126,074 patients with inadequate glycaemic control on metformin alone was estimated to result in 535 CV events and 35 deaths avoided per year at a cost of USD&#xa0;12,250 per CV event avoided or USD&#xa0;189,415 per death avoided. Switching patients currently treated with sitagliptin as an add-on to metformin to gliclazide MR was estimated to avert 26 cardiovascular events (5 MI and 21 HHF) and 2 deaths per year while providing annual savings of USD&#xa0;5.11&#xa0;million, including USD&#xa0;4.77&#xa0;million in drug acquisition costs and USD&#xa0;330,837 in medical costs.</p> Conclusion <p>Initiating gliclazide MR as an add-on treatment to metformin could help to reduce the clinical and economic burden of poorly controlled T2D among patients in the UAE. Switching patients from sitagliptin to gliclazide MR as a second-line treatment option could generate substantial cost savings.</p>

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Cost-Consequences of Adding Gliclazide Modified Release to Metformin in Patients with Uncontrolled Type 2 Diabetes in the United Arab Emirates

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月21日

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  • Mohamed Farghaly,
  • Olivier Cristeau,
  • Fatheya Al Awadi,
  • Sara Al Dallal

摘要

Introduction

Type 2 diabetes (T2D) is a chronic metabolic disease that is highly prevalent in the United Arab Emirates (UAE). This study aimed to assess the cost-consequences of adding gliclazide modified release (MR) to metformin in patients with inadequate glycaemic control on metformin alone and of switching patients currently receiving a combination of sitagliptin and metformin to a combination of gliclazide MR and metformin.

Methods

We developed a cost-consequences decision-tree model comparing gliclazide MR and sitagliptin as second-line add-ons to metformin. Based on 2014–2023 Dubai Real World Claims Database data, the model estimated health outcomes (number of patients reaching HbA1c targets of < 7% and ≤ 6.5% and cardiovascular [CV] events, i.e. myocardial infarction [MI] and hospitalisation for heart failure [HHF]), resource use (inpatient, emergency room, and outpatient visits, and hospital bed days), and costs (drug acquisition and medical costs) associated with the two therapies over a 1-year time horizon from the payer perspective.

Results

Adding gliclazide MR to metformin in a cohort of 126,074 patients with inadequate glycaemic control on metformin alone was estimated to result in 535 CV events and 35 deaths avoided per year at a cost of USD 12,250 per CV event avoided or USD 189,415 per death avoided. Switching patients currently treated with sitagliptin as an add-on to metformin to gliclazide MR was estimated to avert 26 cardiovascular events (5 MI and 21 HHF) and 2 deaths per year while providing annual savings of USD 5.11 million, including USD 4.77 million in drug acquisition costs and USD 330,837 in medical costs.

Conclusion

Initiating gliclazide MR as an add-on treatment to metformin could help to reduce the clinical and economic burden of poorly controlled T2D among patients in the UAE. Switching patients from sitagliptin to gliclazide MR as a second-line treatment option could generate substantial cost savings.