<![CDATA[Type Type 2 Diabetes Mellitus (T2DM) represents a major public health challenge that substantially contributes to long-term healthcare expenditure. Although combination therapy is frequently required to achieve optimal glycemic control, economic considerations play a critical role in selecting appropriate therapeutic regimens. This study aimed to evaluate the cost-effectiveness of metformin–glimepiride (M-G) versus metformin–vildagliptin (M-V) combination therapy in achieving glycemic control among outpatients with T2DM at RSUD dr. Soekardjo, Tasikmalaya. A retrospective observational study employing a cost-effectiveness analysis approach was conducted using medical record data from January to December 2025, involving a total of 32 eligible patients (24 in the M-G group and 8 in the M-V group). Direct medical costs were estimated from the hospital provider perspective, whereas treatment effectiveness was measured by the percentage reduction in random plasma glucose (RPG) levels. The results demonstrated that the M-V combination yielded a higher clinical effectiveness (62.5%) compared to the M-G combination (50%). However, the average direct medical cost was higher in the M-V group (IDR 370,659) than in the M-G group (IDR 244,589). The Average Cost-Effectiveness Ratio (ACER) was lower for the M-G regimen (IDR 4,891.78) than for the M-V regimen (IDR 5,930.54). Furthermore, the Incremental Cost-Effectiveness Ratio (ICER) indicated that each additional 1% improvement in effectiveness achieved with M-V required an additional cost of IDR 10,085.60. Consequently, the M-V combination was considered more cost-effective based on its clinical effectiveness outcomes.]]>
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