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Journal : jurnal farmasi dan ilmu kefarmasian indonesia

A Systematic Review: Cost-Effectiveness of SGLT2 Inhibitors versus DPP-4 Inhibitors as Add-on to Metformin Hanifiyah, Izzatu Al; Nita, Yunita; Libriansyah; Ridwan, Achmad
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 12 No. 2 (2025): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jfiki.v12i22025.256-263

Abstract

Background: The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and dipeptidyl peptidase-4 inhibitors (DPP-4i) are two second-line therapy alternatives for T2DM patients inadequately controlled with metformin. Objective: This study aimed to systematically review the cost-effectiveness of combining metformin+SGLT2i vs metformin+DPP-4i for T2DM treatment. Methods: A systematic search was conducted in PubMed, Scopus, and ScienceDirect for articles published between 2015-2025, using predefined keywords and following the PRISMA and PICOS frameworks (P: T2DM patients uncontrolled on metformin monotherapy; I: Metformin+SGLT2i therapy; C: Metformin+DPP-4i therapy; O: Cost, clinical outcomes (HbA1c% reduction), Incremental Cost-Effectiveness Ratio (ICER) values, Quality Adjusted Life Years (QALY); S: Study with cost-effectiveness analysis design). Additional studies were identified through reference screening. Eligible articles were independently reviewed and assessed for reporting quality using the CHEERS-2022 standards. Results: Five studies met the inclusion criteria. Considerable heterogeneity was observed with mean patient ages ranging from 55-61 years old and baseline HbA1c levels from 7.9%-9.4%. The studies were conducted in the US, UK, Mexico, and Greece, all funded by the pharmaceutical industry, and used economic models. Despite these differences, all studies consistently demonstrated that combining metformin+SGLT2i was more cost-effective than metformin+DPP-4i. SGLT2i improved the quality of life by 0.032–0.04 QALYs, reduced hypoglycemia, and provided additional benefits for patients with cardiovascular risk, although it was associated with higher initial costs. Conclusion: This review showed that the combination of metformin+SGLT2i was more cost-efficient and effective in managing T2DM than the combination of metformin+DPP-4i.
Cost of Illness of Diabetic Foot Ulcer in Lower Middle-Income Countries: A Systematic Review Wulandari, Sinta; Allizaputri, Alfadea Irbah; Libriansyah; Nita, Yunita
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 13 No. 1 (2026): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jfiki.v13i12026.72-83

Abstract

Background: Diabetic foot ulcers (DFU) are a consequence of diabetes mellitus (DM) that cause a significant financial burden on the healthcare system, society, and individuals. The average prevalence of DFU was 6.3%. The cost of diabetic foot care is 50% to 200% higher than that of primary diabetes care. Objective: This systematic review aimed to provide an overview of the variations in the economic burden of DFU in lower middle-income countries (LMICs). Methods: This systematic review examined studies published in English that investigated the costs associated with evaluating diabetic foot disease in LMICs. COCHRANE, CINAHL, DOAJ, EMBASE, GOOGLE SCHOLAR, Ovid MEDLINE, PUBMED, SCIENCE DIRECT, and SCOPUS were used as literature sources without publication date restrictions. Results: A systematic search identified six eligible studies conducted across multiple countries. The studies were published between 2000 and 2024, with study durations ranging from 6 to 12 months. These studies showed large variations in cost components, estimating both direct and indirect costs of the disease. The total costs incurred for DFU vary among LMICs, ranging from USD 379.39 to USD 60,014.81 per year. Conclusion: DFU impose a significant economic burden in LMICs, with substantial variations in cost estimates owing to differences in methodology and data availability. Future studies on the cost burden of DFU should be conducted on a larger scale to obtain more accurate cost estimates.
Co-Authors Abdul Rahem Abdul Rahem, Abdul Achmad Ridwan, Achmad Adinda Siti Almirah Fatima Alfiana Istighfarin Allizaputri, Alfadea Irbah Amanda, Natasya Noor Ana Yuda Ananda Indzar Kholilah Ananda, Yussi Anatasya Andini Setiawan Andi Hermansyah Angelica Kresnamurti Aprilia Purwita Arie Sulistyarini As Sulton, Alfiansyah Maulana Aswarliansyah Ayu Dewi Sartika Bambang Subakti Z Byandra, Naila Devita Ivana Putri Diamita, Bernardina Dihan Asnafin Fadhila Dina Syauqina Hamid Dinara Fathya Rahma P Ditha Carolina Emanuella Elian Haris Darmawan Elida Zairina Fauziyyah Labibah Firdaus, Favian Rafif Gamar, Fahmi Haitsami Ibnu Gesnita Nugraheni Gusti Noorrizka V Hamidah, Nabilah Nur Hanifiyah, Izzatu Al Hasna, Safina Hanifa Hermansyah, Andi I NYOMAN WIJAYA Ihda Nuril Fitriani Iim Suhaemi, Iim Ike Septi Marinda Indah Pratiwi Aryani Kevin Hermawan Hutahaean Kristiani, Ananda Dwi Laras, Kirana Sekar Lestiono Libriansyah M Aqbil Izzul Haq Mahanggi, Oktarina Maldini, Cindy Andrifo Marensa Faradilla Mareta Rindang Andarsari Marita Belia Putri Muhammad Rizky Nabila, Muthma'innatun Nadilah Sobrina Zakiroh Nafi' Nur Hidayah Nafisah Putri Syaharani Najmi MY. Tunggeng Nasywa Ekgi Cahyani Noor Baihaqi, Reihan Ananta Noorrizka, Gusti Nova, Hikmah Octavia, Devi Ristian Pratiwi, Kusma Ayu Priyandani, Yuni Purwitasari, Neny Puspitasari, Hanni Prihhastuti Putri Anggi Aprilia Marcelina Putri, Fida Roesdiana Putri, Sonia Anggitha Rahmawati, Diana Aulia Ridzhan Mawasa Riza Alfian Rokayah Rokayah Rosinta Dewi Anggraeni Sapna Rizka Salsabila Sari, Febrina Kurnia SETIAWAN, Catur Dian Setyawan, Rr. Elmira Sidiq, Kadavi Arafat Silalahi, Zavirah Sinta Wulandari Suhaemi, Iim Talitha Danendra Putri Tsabita, Irdandia Maitsa Tyrzaurra Amalya Maharani Umi Athiyah Umi Athiyah, Umi Virly Natalia Wahyuningtyas, Afifah Rahma Wardhani, Dewanti Wijaya, Aurellia Chance Yuni Priyandani Za'im Hanif Al Fathoni Zahrani, Nafisah Zakiyya, Reyhana Rona