Abstract
OBJECTIVE: To compare the costs associated with glyburide compared to insulin for the treatment of gestational diabetes unresponsive to dietary therapy.
STUDY DESIGN: A cost model was designed. The model excluded costs that were identical for both treatment arms, such as the cost of monitoring glucose control. Insulin treatment costs included average wholesale drug costs, wholesale delivery costs (syringes, alcohol pads), and costs of office staff educating patients. Glyburide costs were based on average wholesale drug costs. Downstream costs of potential inpatient evaluation for hypoglycemia were included in the model.
RESULTS: In our baseline model, glyburide was significantly less costly than insulin for the treatment of gestational diabetes. The average cost saving per patient based on wholesale drug costs and hospital costs was US$165.84. Actual retail drug savings and hospital charge savings are potentially considerably greater. The strongest determinant of cost savings was medication cost. The model was less sensitive to the one-time costs of inpatient treatment and patient education.
CONCLUSION: Glyburide is less costly than insulin for the treatment of gestational diabetes. Cost models can be useful to physicians deciding between two equally efficacious medications, allowing them to incorporate information about their individual practice styles with a complex balance of cost implications.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Gestational Diabetes. ACOG Practice Bulletin No. 30. American College of Obstetricians and Gynecologists Obstet Gynecol 2001; 98: 525–38
American Diabetes Association. Gestational diabetes mellitus Diabetes Care 1998; 21: Suppl 1 S60–1
Picaquadio K, Hollingsworth DR, Murphy H . Effects of in-utero exposure to oral hypoglycaemic drugs Lancet 1991; 338: 866–9
Schaefer-Graf UM, Buchanan TA, Xiang A, Songster G, Montoro M, Kjos SL . Patterns of congenital anomalies and relationship to initial maternal fasting glucose levels in pregnancies complicated by type 2 and gestational diabetes Am J Obstet Gynecol 2000; 182: 313–20
Zucker P, Simon G . Prolonged symptomatic neonatal hypoglycemia associated with maternal chlorpropamide therapy Pediatrics 1968; 42: 237–45
Langer O, Conway DL, Berkus MD, Xenakis EM-J, Gonzales O . A comparison of glyburide and insulin in women with gestational diabetes mellitus N Engl J Med 2000; 343: 1134–8
2000 Drug Topic Red Book Medical Economics 2000
Acknowledgements
This material is the result of work supported with resources and the use of facilities at the Houston Center for Quality of Care and Utilization Studies, Department of Veterans Affairs Health Services Research and Development Center of Excellence, Houston, TX. Special thanks to Glenn Ruggles at the St. Luke's Episcopal Hospital Financial Accounting and Reporting Department for his assistance in providing hospital cost data.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Goetzl, L., Wilkins, I. Glyburide Compared to Insulin for the Treatment of Gestational Diabetes Mellitus: A Cost Analysis. J Perinatol 22, 403–406 (2002). https://doi.org/10.1038/sj.jp.7210759
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jp.7210759