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All Journal Jurnal sistem informasi, Teknologi informasi dan komputer Jurnal Informatika dan Teknik Elektro Terapan JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA E-Dimas: Jurnal Pengabdian kepada Masyarakat Jurnal AKP Metode : Jurnal Teknik Industri Syifa' MEDIKA: Jurnal Kedokteran dan Kesehatan JSFK (Jurnal Sains Farmasi & Klinis) JUPE : Jurnal Pendidikan Mandala Psychology, Evaluation, and Technology in Educational Research Jurnal Riset Pendidikan Kimia (JRPK) Amwaluna Jurnal Ekonomi dan Keuangan Syariah Jurnal Informasi dan Teknologi JATI (Jurnal Mahasiswa Teknik Informatika) Jurnal Inovasi Pendidikan MH Thamrin Jurnal Evaluasi dan Pembelajaran J.Abdimas: Community Health International Journal Software Engineering and Computer Science (IJSECS) Jurnal Kajian Pembelajaran dan Keilmuan Pelita Teknologi : Jurnal Ilmiah Informatika, Arsitektur dan Lingkungan Al-MIKRAJ: Jurnal studi Islam dan Humaniora Jurnal Pengabdian kepada Masyarakat Politeknik Negeri Batam Jurnal Tata Rias (JTR) Journal of Economics and Social Sciences Eduvest - Journal of Universal Studies International Education Trend Issues Applied Quantitative Analysis (AQA) Innovative: Journal Of Social Science Research Information Technology Education Journal ILTEK : Jurnal Teknologi SAINTEK Journal of Innovative and Creativity Jurnal Tata Rias (JTR)
Achmad Ridwan, Achmad
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Journal : JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA

 1 
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.
Co-Authors Abdillah, Nur Afriadi, Bambang Agung Prabowo Agung Prihandono Agung, Eka Adnan Ahmad, Nurul Qomariyah Ahmad, Saiful Aman, Syahrial Andy Wahyu Hermanto, Andy Wahyu Anita Nur Lely, Anita Nur Annisa, Cindy Ermintia Arlinwibowo, Janu Astika Tafrikul Khafidhoh, Astika Tafrikul Athiy Dina Rosihana Athoillah, Mohamad Anton Awaluddin Tjalla Barkah, Eka Cahyani, Septia Dwi Cikita Berlian Hakim Darmiyanti, Waskitarini Delima Sitanggang, Delima Diana Laily Fithri Eko Widodo Febri Dwi Anto, Febri Dwi Firmansyah, Nunung Agus GHAZI PRATAMA, TAFTAZANI Ginting, Riski Titian Hana, Fida Maisa Hanifiyah, Izzatu Al Heri Pramono Putro, Heri Pramono Himayati, Ade Ima Afifa HS, Christnatalis Ibnu Salman, Ibnu Iva Sarifah Josua, Dian Pertiwi Jovianto, Andrean Jubaedah, Dedah Jubaedah, Lilis Judijanto, Loso Junirianto, Eko Komarudin Komarudin Kuncoro, Ignasius Dwi Kurniadewi, Fera Lanasari, Rossy Legiran Legiran Libriansyah Ludmilla, Rafika Madewi, Astuti Manday, Dhanny Rukmana Maricar, Hudzaifah Muhammad Merrydian, Siska Miharja, Muhammad Najamuddin Dwi Muadzah, Muadzah Muhammad Najamuddin Dwi Miharja Muktiningsi, Muktiningsi Muktiningsih Nurjayadi Nadia Dwi Irmadiani Narulita, Lisa Nasution, Edwin Sugesti Nugraheni, Ariyanti Sri Nugroho, Soma Setiawan Ponco Nurcahya, Fikri NURHIDAYATI, SAFITRI Nuridayanti, Nuridayanti Octiva, Cut Susan Perangin Angin, Despaleri Pratama, Taftazani Ghazi Pratiwi, Cindya Yunita Pribadi, Januar Puspitaningtyas, Dyah Ayu Ramadhan, Fitri Nur Ramadhan, M. Irfan Rini, Indah Mustika Riyadi Riyadi Rizky Maulana, Rizky Rochmad Winarso Rohima , Azizah Aulia Rully Astri Hildayati Sabilla, Zahara Sam Saputra, Vernanda Saputra, Vernanda Sam Setiadi, Sandi Setiawan Ponco Nugroho, Soma Siregar, Saut Dohot Siti Azizah Soma Setiawan Ponco Nugroho Sudarmoyo, Dhadhang Tri Sugeng Priyanto, Sugeng Suharjono, Suharjono Suprapto Suprapto Susanti, Diah Ayu Susilo, Ahmad Dwi Tengku Riza Zarzani N Togar Timoteus Gultom Trihadi Prasetya, Trihadi Ully Muzakir Utami, Eli Wahyu Budiarto, Balla Wahyu Sri Astutik Wardani Rahayu Wawan Saputra Widyadi, Elvan Dwi Wijaya, Dedy Achmat Yennimar, Yennimar Yuli Rahmawati Yunida, Helvy Yunita Nita Yunus Mustaqim, Yunus Yusmaniar Yusmaniar Yuyun dwi astutik, Yuyun dwi