OBJECTIVES

: To assess the cost-effectiveness of gliclazide for the treatment of diabetes mellitus type II (DMT II) in comparison with glibenclamide and tolbutamide, two of the most used interventions from the perspective of Mexican public health institutions.

METHODS

: The type of economic evaluation that was carried out is a cost-effectiveness analysis to estimate the costs and health consequences in terms of years of life gained, considering relevant complications that may exist during the natural history of the disease such as terminal chronic renal failure, blindness, acute myocardial infarction, angina pectoris, cerebrovascular accident, heart failure and hypoglycemia events. The model was carried out through a simulation of discrete events. The alternatives were: 1) gliclazide, 2) glibenclamide and 3) tolbutamide as the two last ones are available on the Mexican national list of medicines. A lifetime horizon of the patients’ life was applied, with the option of selecting a desired horizon of 10, 20 and 30 years.

RESULTS

: Over a 20-year time horizon, and applying 100 simulations, the use of gliclazide has demonstrated:

• To increase life-years gained of approximately 3 and 5 years in comparison with the patients treated with glibenclamide and tolbutamide respectively.
• To be a cost-effective option: (ICER: vs tolbutamide: 5,213 €/LYG vs glibenclamide: 5,727 €/LYG ) for the treatment of patients with diabetes mellitus type 2.
• Additionally to that, the use of gliclazide has demonstrated to reduce all complications associated with diabetes mellitus type 2 versus glibenclamide and tolbutamide.

CONCLUSIONS

: This study has demonstrated that gliclazide is associated with clinical benefits at an affordable cost over a 20 years horizon, in comparison with glibenclamide and tolbutamide for the public health institutions in Mexico