Review: Cost-Effectiveness Analysis Metformin dan Dipeptidyl Peptidase-4 Inhibitor Dibandingkan dengan Metformin dan Sulfonilurea pada Pasien Diabetes Melitus Tipe 2

Nuring Novita Kusumawati, Tri Murti Andayani

Abstract

Prevalensi diabetes melitus tipe 2 (DMT2) meningkat, sehingga manajemen terapi yang efektif dan cost-effective sangat penting. Kombinasi metformin dengan dipeptidyl peptidase-4 inhibitor (DPP-4 inhibitor) dan metformin dengan sulfonilurea (SU) merupakan terapi lini kedua pada pasien DMT2, masing-masing memiliki kelebihan dan kekurangan terkait biaya dan efektivitas. Review ini bertujuan untuk membandingkan hasil penelitian cost-effectiveness dari kedua kombinasi tersebut guna membantu praktisi kesehatan dalam membuat keputusan pemilihan terapi dalam pengelolaan DMT2. Review ini menganalisis temuan dari berbagai jurnal yang dipublikasikan secara online, menggunakan database SCOPUS dan PubMed serta mengikuti skema PRISMA dan PICO.  Penelitian yang memenuhi kriteria pencarian adalah 75 studi, 35 di antaranya berasal dari Scopus dan 40 PubMed. Terdapat beberapa artikel dikecualikan dan didapatkan 5 studi yang memenuhi kriteria akhir kemudian dilakukan penilaian kualitas berdasarkan standar CHEERS 2022. Analisis menunjukkan bahwa kombinasi DPP-4 inhibitor dan metformin lebih efektif dibandingkan kombinasi sulfonilurea dan metformin dalam mengelola diabetes melitus tipe 2, temuan ini didukung oleh pemelitian dari berbagai negara, menunjukkan pengurangan risiko hipoglikemia dan peningkatan kualitas hidup pasien. Tinjauan sistematis ini menunjukkan bahwa kombinasi DPP-4 inhibitor dengan metformin adalah terapi lini kedua yang cost effective dibandingkan dengan kombinasi sulfonilurea dan metformin untuk penderita diabetes melitus tipe 2.

Keywords

Cost-effectiveness analysis; Diabetes melitus; DPP-4 inhibitor; Farmakoekonomi; Metformin; Sulfonilurea

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References

Ahrén, B. (2008). Novel combination treatment of type 2 diabetes DPP-4 inhibition + metformin. Vascular Health and Risk Management, 4(2), 383–394.

Baker, C., Retzik-Stahr, C., Singh, V., Plomondon, R., Anderson, V., & Rasouli, N. (2020). Should metformin remain the first-line therapy for treatment of type 2 diabetes? TTherapeutic Advances in Endocrinology and Metabolism, 12, 1–13. https://doi.org//10.1177/20420188

Chien, C. L., Chen, Y. C., Malone, D. C., Peng, Y. L., & Ko, Y. (2020). Cost-utility analysis of second-line anti-diabetic therapy in patients with type 2 diabetes mellitus inadequately controlled on metformin. Current Medical Research and Opinion, 36(10), 1619–1626. https://doi.org/10.1080/03007995.2020.1815686

Erhardt, W., Bergenheim, K., Duprat-Lomon, I., & McEwan, P. (2012). Cost effectiveness of saxagliptin and metformin versus sulfonylurea and metformin in the treatment of type 2 diabetes mellitus in Germany: A cardiff diabetes model analysis. Clinical Drug Investigation, 32(3), 189–202. https://doi.org/10.2165/11597060-000000000-00000

Fadini, G. P., Bottigliengo, D., D’Angelo, F., Cavalot, F., Bossi, A. C., Zatti, G., Baldi, I., Avogaro, A., Consoli, A., Formoso, G., Grossi, G., Pucci, A., Sesti, G., Andreozzi, F., Capobianco, G., Gatti, A., Bonadonna, R., Zavaroni, I., Cas, A. D., … Vinci, C. (2018). Comparative Effectiveness of DPP-4 Inhibitors Versus Sulfonylurea for the Treatment of Type 2 Diabetes in Routine Clinical Practice: A Retrospective Multicenter Real-World Study. Diabetes Therapy, 9(4), 1477–1490. https://doi.org/10.1007/s13300-018-0452-y

Gardete-Correia, L., Boavida, J. M., Raposo, J. F., Mesquita, A. C., Fona, C., Carvalho, R., & Massano-Cardoso, S. (2010). First diabetes prevalence study in Portugal: PREVADIAB study. Diabetic Medicine, 27(8), 879–881. https://doi.org/10.1111/j.1464-5491.2010.03017.x

Gong, L., Goswami, S., Giacomini, K. M., Altman, R. B., & Klein, T. E. (2012). Metformin pathways. Pharmacogenetics and Genomics, 22(11), 820–827. https://doi.org/10.1097/FPC.0b013e3283559b22

Granström, O., Bergenheim, K., McEwan, P., Sennfält, K., & Henriksson, M. (2012). Cost-effectiveness of saxagliptin (Onglyza®) in type 2 diabetes in Sweden. Primary Care Diabetes, 6(2), 127–136. https://doi.org/10.1016/j.pcd.2011.09.003

Gu, S., Deng, J., Shi, L., Mu, Y., & Dong, H. (2015). Cost-effectiveness of saxagliptin vs glimepiride as a second-line therapy added to metformin in Type 2 diabetes in China. Journal of Medical Economics, 18(10), 808–820. https://doi.org/10.3111/13696998.2015.1049542

Haddaway, N. R., Page, M. J., Pritchard, C. C., & McGuinness, L. A. (2022). PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis. Campbell Systematic Reviews, 18(2), e1230. https://doi.org/https://doi.org/10.1002/cl2.1230

IDF. (2021). Five questions on the IDF Diabetes Atlas. Diabetes Research and Clinical Practice, 102(2), 1–141. https://doi.org/10.1016/j.diabres.2013.10.013

Isnaini, N., & Ratnasari, R. (2018). Faktor risiko mempengaruhi kejadian Diabetes mellitus tipe dua. Jurnal Kebidanan Dan Keperawatan Aisyiyah, 14(1), 59–68. https://doi.org/10.31101/jkk.550

Kim, D. D., Silver, M. C., Kunst, N., Cohen, J. T., Ollendorf, D. A., & Neumann, P. J. (2020). Perspective and Costing in Cost-Effectiveness Analysis, 1974–2018. PharmacoEconomics, 38(10), 1135–1145. https://doi.org/10.1007/s40273-020-00942-2

Kwon, C. S., Seoane-Vazquez, E., & Rodriguez-Monguio, R. (2018). Cost-effectiveness analysis of metformin+dipeptidyl peptidase-4 inhibitors compared to metformin+sulfonylureas for treatment of type 2 diabetes. BMC Health Services Research, 18(1), 1–12. https://doi.org/10.1186/s12913-018-2860-0

Mursalin, & Soewondo, P. (2017). Analisis Estimasi Biaya Langsung Medis Penderita Rawat Jalan Diabetes Mellitus Tipe 2 di RSUD Dr. Abdul Aziz Singkawang Tahun 2013. Jurnal Ekonomi Kesehatan Indonesia, 1(2), 5–15. https://doi.org/10.7454/eki.v1i2.1770

PERKENI. (2021). Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia 2021. In Perkeni (2021st ed.). PB PERKENI. www.ginasthma.org.

Rai, M., & Goyal, R. (2017). Pharmacoeconomics in Healthcare. In Pharmaceutical Medicine and Translational Clinical Research. Elsevier Inc. https://doi.org/10.1016/B978-0-12-802103-3.00034-1

Satibi. (2014). Manajemen Obat di Rumah Sakit. Manejemen Adminsitrasi Rumah Sakit, 8(5), h: 6-7, 9-10.

Schwinghammer, T. L., DiPiro, J. T., Ellingrod, V., & DiPiro, C. V. (2023). DiPiro’s Pharmacotherapy Handbook, 12th Edition (12th ed.). McGraw-Hill Education. https://books.google.co.id/books?id=yTttzwEACAAJ

Shaikh, S., Lee, E. J., Ahmad, K., Ahmad, S. S., Lim, J. H., & Choi, I. (2021). A comprehensive review and perspective on natural sources as dipeptidyl peptidase-4 inhibitors for management of diabetes. Pharmaceuticals, 14(6). https://doi.org/10.3390/ph14060591

Viriato, D., Calado, F., Gruenberger, J. B., Ong, S. H., Carvalho, D., Silva-Nunes, J., Johal, S., & Viana, R. (2014). Cost-effectiveness of metformin plus vildagliptin compared with metformin plus sulphonylurea for the treatment of patients with type 2 diabetes mellitus: A Portuguese healthcare system perspective. Journal of Medical Economics, 17(7), 499–507. https://doi.org/10.3111/13696998.2014.912986

DOI: https://doi.org/10.20961/jpscr.v9i2.91911

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