OBJECTIVES: This study aims to present an economic evaluation of using liquid metformin for pediatric patients with metabolic syndrome at risk of developing DM2 within the context of Mexican public health institutions.

METHODS: First, we modeled the effectiveness of the analyzed alternatives using the incidence rates of DM2 in each treatment group; the first group received lifestyle change recommendations, while the second group received metformin in addition to the above. Then, we incorporated these results into a Markov chain analysis over a 4-year time horizon for each treatment group. For sensitivity analysis, we conducted a probabilistic analysis to assess our evaluation in various uncertainty scenarios.

RESULTS: We found that liquid metformin use is associated with 0.24 additional years without developing DM2 and incremental savings of $20,457.01, resulting in a dominant intervention compared to the untreated control. The probabilistic sensitivity analysis revealed that 100% of iterations favored liquid metformin over the untreated control, indicating that it not only has superior effectiveness in terms of DM2-free years but also generates significant incremental savings. This finding maintains liquid metformin's dominance over no-treatment alternatives.

CONCLUSIONS: Preventive intervention using metformin was found to be a cost-saving and effective strategy for managing type 2 diabetes risk. Liquid metformin increases type 2 diabetes-free life years for pediatric patients, directly contributing to improved life expectancy. From the perspective of public health institutions and decision-makers, this intervention saves more money than preventive conferences or standard lifestyle advice in a population at risk of developing the disease.