Pharmacoeconomic Evaluation of Antidiabetic Therapy and Economic Burden of Diabetes Management in a Tertiary Care Hospital

Background

Type 2 Diabetes Mellitus (T2DM) represents a pervasive metabolic disorder characterized by progressive deterioration of glycaemic homeostasis and an escalating requirement for long-term therapeutic intervention. The chronicity of the disease, coupled with the necessity for pharmacotherapeutic intensification and management of diabetes-associated complications, contributes substantially to healthcare resource consumption and financial burden, particularly within resource-limited healthcare environments.

Objectives

To critically evaluate the pharmacoeconomic attributes of antidiabetic pharmacotherapy, quantify direct medication-related expenditures, examine prescribing trends, and determine the magnitude of the economic burden associated with diabetes management in a tertiary care healthcare setting.

Materials and Methods

A prospective observational pharmacoeconomic study was undertaken among 400 patients diagnosed with Type 2 Diabetes Mellitus receiving treatment at a tertiary care teaching hospital. Detailed information pertaining to antidiabetic prescribing patterns, therapeutic regimens, insulin utilization, fixed-dose combinations, associated comorbidities, and medication acquisition costs was systematically documented and analyzed. Direct treatment costs were estimated using prevailing market prices, and monthly as well as annual expenditures were calculated to assess the economic implications of diabetes pharmacotherapy.

Results

Considerable variability in treatment expenditure was observed across antidiabetic therapeutic classes. Metformin emerged as the most economically advantageous pharmacological agent, with an estimated monthly cost ranging from ₹80-250, whereas insulin glargine constituted the highest-cost therapeutic option, with monthly expenditures ranging from ₹2200-4500. Treatment costs demonstrated a progressive increase in parallel with therapeutic complexity, rising from ₹180-600 for monotherapy to ₹2500-7000 for insulin-based regimens. Annual expenditure ranged from ₹2400-7200 for metformin monotherapy to ₹54,000-1,08,000 for insulin analogue-based therapy. Generic prescribing practices were associated with markedly lower treatment costs compared with branded prescribing. Furthermore, patients with chronic kidney disease and coronary artery disease incurred the greatest economic burden. New-generation antidiabetic agents, particularly DPP-4 inhibitors and SGLT2 inhibitors, were identified as major contributors to overall treatment expenditure.

Conclusion

Diabetes management imposes a substantial and progressively increasing economic burden, driven primarily by therapeutic intensification, utilization of insulin analogues, and the coexistence of chronic comorbid conditions. Adoption of rational prescribing practices, promotion of generic formulations, and implementation of strategies aimed at preventing disease progression and complications may enhance pharmacoeconomic efficiency and mitigate long-term healthcare expenditures.