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Cost-effectiveness analysis of metformin versus insulin in the treatment of gestational diabetes mellitus

  • Maternal-Fetal Medicine
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Abstract

Objective

Although there have been many studies on gestational diabetes mellitus (GDM) treatment, there is still a knowledge gap regarding the comparative cost-effectiveness of metformin and insulin in the treatment phase. Existing studies have focused on treatment efficacy and drug safety, but relatively little has been explored regarding cost-effectiveness analysis. In particular, no comprehensive study has evaluated the cost-effectiveness of metformin and insulin for GDM treatment. Therefore, this study aimed to fill this knowledge gap by conducting a cost-effectiveness analysis of these two treatments for GDM.

Methods

A decision-analytic model was used to compare the cost-effectiveness of metformin and insulin in China. Probabilities, costs, and utilities were derived from the literature. The cost and quality-adjusted life years (QALYs) were calculated using the roll-back method. The strategy was considered cost-effective if the incremental cost-effectiveness ratio (ICER) was below the willingness-to-pay (WTP) threshold of ¥242,938 per QALY. Sensitivity analyses were also conducted to assess the robustness of the results.

Results

The roll-back analysis indicated that insulin was not cost-effective compared to metformin, resulting in increased costs and decreased QALYs, with a negative ICER. These findings suggested that metformin is a cost-effective option than insulin. Furthermore, the sensitivity analysis showed that the model was robust.

Conclusions

Compared with insulin, metformin is a cost-effective treatment option for GDM.

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Data availability

All included studies are available in a major database.

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Acknowledgements

We would like to thank the library of Shenyang Pharmaceutical University for their help in retrieving the literature.

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This research received no external funding.

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Authors and Affiliations

  1. School of Life Sciences and Biopharmaceuticals, Shenyang Pharmaceutical University, Shenyang, China

    Rui Wu

  2. School of Medical Devices, Shenyang Pharmaceutical University, Shenyang, China

    Zuo**g Li

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ZJL: Protocol development, Data collection, Data analysis, and Manuscript writing. RW: Data analysis, Manuscript writing, and Manuscript editing.

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Correspondence to Zuo**g Li.

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Wu, R., Li, Z. Cost-effectiveness analysis of metformin versus insulin in the treatment of gestational diabetes mellitus. Arch Gynecol Obstet 310, 135–144 (2024). https://doi.org/10.1007/s00404-024-07483-5

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