Global Long-Term Cost Effectiveness of Newer Antidiabetic Drugs for Type 2 Diabetes Mellitus: A Systematic Review
Abstract
Background and objective: The rising global burden of type 2 diabetes mellitus, compounded by the expanding therapeutic landscape, has placed increasing pressure on health systems to generate robust evidence on the long-term value for money of newer antidiabetic drugs (NADs). This systematic review addresses the urgent need for an updated synthesis of evidence on long-term health economic evaluations of NADs for the treatment of type 2 diabetes, including studies on the latest agents such as tirzepatide and finerenone. It aims to synthesise global long-term cost-effectiveness analyses, assess reporting completeness using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 framework and outline key implications for clinicians, payers and policymakers seeking to optimise type 2 diabetes management within resource-constrained health systems.
Methods: PubMed, Embase, Cochrane, EBSCOhost, Scopus and Web of Science were systematically searched for studies published between 1 January, 2008 and 20 February, 2025. Eligible studies were long-term incremental cost-effectiveness analyses conducted in adults with type 2 diabetes, comparing NADs with other NAD classes or with standard treatment, and reporting outcomes such as incremental cost-effectiveness ratios. A formal risk of bias assessment using tools designed for clinical trials was not undertaken. Instead, reporting quality and transparency were assessed using the CHEERS 2022 checklist, with…
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