Cost-Effectiveness Analysis of Teneligliptin V/S Glimepiride as an Add-on to Metformin in Type 2 Diabetes Mellitus
Abstract
Diabetes is a major lifestyle disorder and its prevalence is increasing with a huge economic burden to countries. Patients with Type 2 diabetes suffers a lot of vascular complications and die earlier with cardiovascular diseases. Proper glycemic control is needed to prevent the development of these complications. Glimepiride is a second-generation sulphonyl urea with better safety and efficacy is commonly prescribed comparing to other drugs of that class. teneligliptin is relatively newer dipeptidyl peptidase inhibitor with proven clinic with metformin. More cost-effective treatment option is important in case of people with poor economic background for better adherence and thereby preventing complications and economic burden. A comparative evaluation of these combination based on cost effectiveness analysis will help to prioritize resource allocation. A prospective observation study in a tertiary care hospital and further cost effectiveness analysis revealed that glimepiride metformin combination shown better effectiveness in terms of both FBS and PPBS reduction. Teneligliptin and metformin therapy shown satisfactory reduction in blood glucose levels, but is much costlier. Compared to teneligliptin, glimepiride is a better choice as an add on drug in the absence of any contraindication in patients who are highly concerned about cost, to reduce economic burden and to improve adherence, when used as an initial combination in patients with Type 2 diabetes mellitus.Gavina C, Carvalho DS, Dias DM, Bernardo F, Martinho H, Couceiro J, Santos-Araújo C, Dinis-Oliveira RJ, Taveira-Gomes T. Premature Mortality in Type 2 Diabetes Mellitus Associated with Heart Failure and Chronic Kidney Disease: 20 Years of Real-World Data. Journal of Clinical Medicine. 2022; 11(8):2131. https://doi.org/10.3390/jcm11082131
Haghighatpanah M, Nejad ASM, Haghighatpanah M, Thunga G, Mallayasamy S. Factors that Correlate with Poor Glycemic Control in Type 2 Diabetes Mellitus Patients with Complications. Osong Public Health Res Perspect. 2018 Aug;9(4):167-174. doi: 10.24171/j.phrp.2018.9.4.05. PMID: 30159222; PMCID: PMC6110332.
Simeon I Taylor et al Pharmacological Treatent of Hyperglycemia in Type 2 diabetes The Journal of Clinical investigations 2021 Jan19;131(2): e142243.doi:10.1172/JCI142243.
Bernard Zinman, Initial Combination Therapy for Type 2 Diabetes Mellitus: Is It Ready for Prime Time? The American Journal of Medicine,Volume 124, Issue 1, Supplement, 2011,Pages S19-S34,ISSN 0002-9343,https://doi.org/10.1016/j.amjmed.2010.11.003.
(https://www.sciencedirect.com/science/article/pii/S0002934310009174)
Hermann LS. Metformin: a review of its pharmacological properties and therapeutic use. Diabetes & Metabolism. 1979 Sep;5(3):233-245. PMID: 387488.
Deacon CF, Lebovitz HE. Comparative review of dipeptidyl peptidase-4 inhibitors and sulphonylureas. Diabetes Obes Metab. 2016 Apr;18(4):333-47. doi: 10.1111/dom.12610. Epub 2016 Jan 8. PMID: 26597596.
Sahay RK, Mittal V, Gopal GR, Kota S, Goyal G, Abhyankar M, Revenkar S. Glimepiride and Metformin Combinations in Diabetes Comorbidities and Complications: Real-World Evidence. Cureus. 2020 Sep 28;12(9):e10700. doi: 10.7759/cureus.10700. PMID: 33133865; PMCID: PMC7594657.
Kanimozhi M, Bisht M, Ravikant, Bandyopadhyay A, Naithani M, Handu S. Pleiotropic effect of teneligliptin versus glimepiride add-on therapy on hs-CRP and cardiorenal parameters in Indian type 2 diabetes patients: An open-labeled randomized controlled trial. Perspect Clin Res. 2025 Jan-Mar;16(1):14-22. doi: 10.4103/picr.picr_265_23. Epub 2024 Jul 10. PMID: 39867519; PMCID: PMC11759232.
Bommer C, Heesemann E, Sagalova V, Manne-Goehler J, Atun R, Bärnighausen T, Vollmer S. The global economic burden of diabetes in adults aged 20-79 years: a cost-of-illness study. Lancet Diabetes Endocrinol. 2017 Jun;5(6):423-430. doi: 10.1016/S2213-8587(17)30097-9. Epub 2017 Apr 26. PMID: 28456416.
Pradeepa R, Mohan V. Epidemiology of type 2 diabetes in India. Indian J Ophthalmol. 2021 Nov;69(11):2932-2938. doi: 10.4103/ijo.IJO_1627_21. PMID: 34708726; PMCID: PMC8725109.
Rasheed, Razia Abdul; Venkatraman, G.1; Vijayalakshmi, S.; Raja, T. A. R.; Senthil, G.; Renugadevi, P.. Effect of glimepiride versus teneligliptin in combination with metformin in type 2 diabetes mellitus patients. Indian Journal of Pharmacology 56(5):p 317-321, Sep–Oct 2024. | DOI: 10.4103/ijp.ijp_107_24
Tandon T, Dubey AK, Srivastava S, Manocha S, Arora E, Hasan N. A pharmacoeconomic analysis to compare cost-effectiveness of metformin plus teneligliptin with metformin plus glimepiride in patients of type-2 diabetes mellitus. J Family Med Prim Care. 2019 Mar;8(3):955-959. doi: 10.4103/jfmpc.jfmpc_22_19. PMID: 31041232; PMCID: PMC6482796.
Nishanth T, Maheshwari CU, Lakshmi RS, Sri D, Goud P, Tabassum K, Nadeem MT. A study to compare efficacy of metformin-glimepiride versus metformin-teneligliptin in type II diabetic patients. Int J Pharm Sci Res. 2018 Dec 1;9(12):5258-64.
Anjoom M, Dutta S, Beg MA, Varma A, Bawa S, Kant R. Comparative evaluation of combination of metformin and glimepiride with that of metformin and sitagliptin in type 2 diabetes mellitus with respect to glycemic targets. Int J Med Sci Public Health. 2015 Apr 1;4(4):476-80.
John NN, Arjun VJ, David D, Doddayya H. Pharmacoeconomic Evaluation of Antidiabetic Agents-Metformin Plus Teneligliptin Versus Metformin Plus Glimepiride-A Prospective Study.
Gautam A, Singh SV, Gupta A, Sharma A, Gupta S, Pursnani N, Agrawal P. Comparison of efficacy between canagliflozin and teneligliptin as add-on therapy to metformin and glimepiride on plasma glucose levels along with blood pressure and lipid levels in patients with type 2 diabetes mellitus. Journal Of Diabetology. 2023 Jul 1;14(3):157-60.
| Files | ||
| Issue | Vol 11 No 2 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| diabetes mellitus cost effectiveness metformin hydrochloride glimepiride teneligliptin. | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |

