Cost-effectiveness analysis of intensive blood-glucose control with metformin in overweight patients with Type II diabetes (UKPDS No. 51)

Aims/hypothesis. To estimate the economic efficiency of intensive blood-glu cose control with metformin compared with conventional therapy primarily wi th diet in overweight patients with Type II (non-insulin-dependent) diabete s mellitus. Methods. Cost-effectiveness analysis based on patient level data from a ran domised clinical controlled trial involving 753 overweight (> 120 % ideal b ody weight) patients with newly diagnosed Type II diabetes conducted in 15 hospital-based clinics in England, Scotland and Northern Ireland as part of the UK Prospective Diabetes Study. Subjects were allocated at random to an intensive blood-glucose control policy with metformin (n = 342) or a conve ntional policy primarily with diet (n = 411). The analysis was based on the cost of health care resources associated with metformin and conventional t herapy and the estimated effectiveness in terms of life expectancy gained f rom within-trial effects. Results. Intensive blood-glucose control with metformin produced a net savi ng of pound 258 per patient (1997 United Kingdom prices) over the trial per iod (median duration of 10.7 years) due to lower complication costs, and in creased life expe ctancy by 0.4 years (costs and benefits discounted at 6 %). Conclusions/int erpretation. As metformin is both cost-saving in the United Kingdom and ext ends life expectancy when used as first line pharmacological therapy in ove rweight Type II diabetic patients, its use should be attractive to clinicia ns and health care managers alike.