PHARMACOECONOMICAL EVALUATION OF ORAL HYPOGLYCEMIC AGENTS FOR TYPE-2 DIABETES MELLITUS IN A MULTISPECIALITY HOSPITAL

The objective of the study was to determine the cost effective drug among oral hypoglycemic agents utilized in a multispeciality hospital to treat type-2 diabetes mellitus. The prospective cost effectiveness study was conducted for 6 months period in patients who were diagnosed with type-2 diabetes mellitus and were receiving treatment specifically with oral hypoglycemic agent(s). The data obtained was introduced to Incremental Cost Effectiveness Ratio determination to arrive at the most cost effective drug and the prescription pattern and drug related problems in the patients were monitored. A total of 141 patients were included in the study. Glipizide among monotherapy (p<0.01), Glimepiride as add on therapy to Metformin (p<0.001), fixed dose triple combination of Glimepiride, Pioglitazone and Metformin (p<0.01) and fixed dose combination of Glimepiride and Metformin (p<0.001) were found to be more effective using statistical analysis. Most of the patients were receiving fixed dose combinations (43.6%) out of which Glimepiride and Metformin combination (34.42%) was predominant over the others. Serious drug interactions (12) and adverse drug reactions (5) were monitored. For Type 2 Diabetes Mellitus, Metformin among monotherapy, Glimepiride as an add on to Metformin, fixed dose triple combination of Glimepiride, Pioglitazone and Metformin can be considered as the best drug of choice with respect to cost effectiveness.