Value for money?

A recent report compared the costs of newer anti-diabetic medications.  This included glitazones, exenatide and gliptins.  The cheapest of these costs about £400 a year per patient compared with under £10 for a sulphonylurea and under £20 for metformin.

The two important questions are :

1.  Are the newer medications 20 times as good as metformin?
2.  Is it better, purely on a cost basis, to treat twenty people with metformin or one person with a gliptin?

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