OBJECTIVES: To compare health-care costs of diabetic patients who start treatment with Sitagliptin (SITA) or Sulphonylurea (SUL), using Health Information Systems (HIS) of the Marche region.

METHODS: From HIS, which collects information related to hospitalizations, drugs prescriptions and outpatient visits, we identified all diabetic patients who started treatment with SITA or SUL in addition to MET, during the period 2009-2011. To identify the cohort of interest, we applied the following inclusion criteria:

• first prescription (index-prescription) of SITA (ATC A10BH01, A10BD07) or SUL (ATC A10BB, A10BD02);
• adherence to SITA or SUL treatment, measured by Medication Possession Ratio (MPR), ≥80%.
• adherence to MET (ATC A10BA02) treatment, MPR≥80%, during the year before the index-prescripton.

Selected patients were stratifyed in SITA or SUL users, according to the index-prescription; demographics and clinical characteristics were assessed at baseline and a propensity score-matching analysis (PSM) was used to balance the two groups.

Health-care costs for drugs, outpatient visits and hospitalizations were calculated for the 3 years following the index-prescription.

RESULTS: Applying the PSM, 340 patients (82.7% of total patients) were paired, for which no statistically significant differences were observed for variables considered at baseline.

The analysis showed a higher cost for the first year of treatment for patients treated with SITA (€1,471) compared to those treated with SUL (€1,018). From the second year of treatment the cost of patients treated with SITA was systematically lower: €1,235 vs €1,315 in the second year and €1,414 vs. €1,710 in the third year.

CONCLUSIONS: The study, based on italian administrative databases, allowed to estimate the health-care costs of patients treated with SITA or SUL, highlighting a progressive reduction in costs for SITA treated patients starting from the second year of treatment.