<![CDATA[ABSTRACT Type 2 diabetes mellitus (T2DM) is a chronic disease requiring lifelong treatment and imposing a considerable economic burden on healthcare systems. This study aimed to evaluate the cost–utility of metformin and gliquidone therapy among patients with T2DM treated at a regional hospital in Indonesia. An analytical observational study with a cross-sectional design was conducted among 60 outpatients with T2DM between May and June 2025, including 40 patients receiving metformin and 20 receiving gliquidone. Direct medical costs were obtained from medical records, while health utility was assessed using the EQ-5D-5L questionnaire and converted into utility scores using the Indonesian EQ-5D-5L value set. Cost–utility analysis was performed using the Average Cost–Utility Ratio (ACUR) and Incremental Cost–Utility Ratio (ICUR), with health utility scores as the effectiveness outcome. Metformin therapy demonstrated lower direct medical costs than gliquidone (IDR 140,225 vs IDR 183,687). Mean utility scores were 0.776 and 0.749, respectively. Metformin produced the lowest ACUR (IDR 180,703 per utility score), whereas gliquidone showed an ACUR of IDR 245,243 per utility score. Incremental analysis indicated that gliquidone incurred higher treatment costs while providing lower health utility than metformin, indicating that gliquidone was economically dominated by metformin. Overall, metformin demonstrated the most favorable cost–utility profile and remains the preferred first-line therapy for patients with T2DM, while gliquidone may be considered in selected clinical conditions.]]>
