Cost analysis of antidiabetic drugs for diabetes mellitus outpatient in Kodya Yogyakarta Hospital

Diabetes mellitus is a chronic disorder that has been recognised by the Indonesian government as a major public health problem with far reaching consequences not just for its adverse impact on the health of Indonesians, but also for the economic burden it places on the healthcare systems. The objectives of this study were to describe the healthcare cost for outpatient diabetes mellitus treatment and to examine the cost of different classes of antidiabetic drugs. The medical records of Type 2 diabetes mellitus outpatients without compelling indication were retrospectively reviewed. Data was collected for patients treated from January 1st to December 31st, 2004 in Kodya Yogyakarta Hospital. Data collected included patient demographics, drug acquisition cost, medical consultation cost and laboratory cost. We analysed charts of 100 consecutive patients, of whom 71% are women and 29% are men. The average age of patient was 61.2 ± 13.7 years. The monthly mean cost of Type 2 diabetes mellitus was found to be equivalent to USD19.97 ± 13.71. Most of the direct medical costs were spent on drugs (96.4%). Blood glucose control using combination therapy was more frequently attained in patients taking glibenclamide and metformin (25%). The combination of gliquidone-metformin-acarbose (21%) was the most expensive, which was equivalent to USD39.44. The potential saving was 6.10% of total drug cost if generic substitutions were prescribed for diabetes mellitus in place of more expensive drugs. In conclusion, we identified that the costs of diabetes mellitus outside of hospitals are mainly dependent on the expenses with blood glucose-lowering drugs.