A COST-MINIMIZATION STUDY TO DETERMINE THE IMPACT OF ADDING GLUCOVANCE TO A COUNTY HOSPITAL FORMULARY

ABSTRACT

OBJECTIVE: This study is conducted to determine the economic impact of the addition of a new diabetic agent, Glucovance (metformin/glyburide) to a county hospital system with over 21,000 diabetic patients. METHODS: A cost minimization analysis between Glucovance and metformin plus any of the sulfonylureas is conducted. Initially, a database of all diabetic patients in the county hospital system is created to determine total number of patients who are being treated with metformin alone and in combination with other sulfonylureas, glipizide XL, generic glipizide, glyburide, and glimepiride. Next, the cost difference between treating with Glucovance alone or as a dual therapy with both metformin 500mg plus the most common dose of each sulfonylurea is calculated to determine the incremental cost savings over a year's time of therapy. Only the direct costs of the drugs involved are utilized in this study. RESULTS: The results indicate that if all of the 6,622 patients who are on dual therapy with both metformin 500mg and a usual maintenance dose of a sulfonylurea drug are switched to the new combination product, the county system can save over half a million dollars ($555,566.00) in a year, in direct drug costs alone. CONCLUSION: These results illustrate that there is an economic incentive to add the new combination product to the formulary. However, future cost-effectiveness studies are needed to determine the impact of this decision both in terms of clinical and economic outcomes.