Clinical effectiveness and cost‐effectiveness of first‐line early combination of dipeptidyl peptidase 4 inhibitors and metformin in patients with type 2 diabetes in Taiwan: A modelling study
Authors' conclusion
Early DPP4i-Met provides long-term clinical and economic benefits compared to Met alone for newly diagnosed T2D patients, including those with young-onset T2D.
Study context
- Population
- Treatment-naïve T2D patients with inadequately controlled HbA1c (≥8.5%), Taiwan; model inputs from Taiwanese or Asian populations
- Comparison
- Early DPP4i-Met combination vs Met alone
- Outcome
- NNT to prevent one case of a clinical event and incremental cost-effectiveness ratios (ICERs)
- Follow-up
- Lifetime (40 years of projection)
Methodological detailscost-effectiveness analysis, IQVIA CORE Diabetes Model, lifetime horizon, Taiwan National Health Insurance Administration perspective, quality-adjusted life years (QALYs) and costs discounted at 3% annually, costs in 2023 US dollars
- Cost-effectiveness analysis
- IQVIA CORE Diabetes Model
- Lifetime horizon
- Taiwan National Health Insurance Administration perspective
- QALYs and costs discounted at 3% annually
- Costs in 2023 US dollars
Main finding
As reported in the abstract
NNT (DPP4i-Met vs Met) to prevent one case · 40 years
- NNT to prevent one case of stroke
- 45
- NNT to prevent one case of microalbuminuria
- 135
- NNT to prevent one case of neuropathy
- 65
- NNT to prevent one case of background retinopathy
- 182
- QALYs gained with DPP4i-Met vs Met, overall treatment-naïve T2D
- 0.086
- Savings with DPP4i-Met vs Met, overall treatment-naïve T2D
- $489
Further findings
| Outcome | DPP4i-Met | Met | Reduction in incidence (CI) |
|---|---|---|---|
| Stroke incidence · 40 yearsLower with DPP4i-Met | 2.21% (2.68–1.74) | ||
| Treatment cost per person | $5796 /person | $5484 /person |
Stroke incidence · 40 years
- Fewer complications with DPP4i-Met than Met alone
Treatment cost per person
- Higher treatment cost offset by fewer costly complications
QALYs and costs, young-onset T2D
- QALYs gained with DPP4i-Met vs Met
- 0.064
- Savings with DPP4i-Met vs Met
- $714
Original publication
Clinical effectiveness and cost‐effectiveness of first‐line early combination of dipeptidyl peptidase 4 inhibitors and metformin in patients with type 2 diabetes in Taiwan: A modelling study. Diabetes Obes Metab. Published 30 January 2025. doi:10.
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