Metformin Underused as Diabetes Prevention Strategy

Prescribing metformin for prediabetes could reduce healthcare costs by $820 million annually.

A recent CDC report indicated that more than 30.3 million Americans—9.4% of the US population—had diabetes and 84.1 million had prediabetes in 2015. Without effective intervention, millions of Americans with prediabetes progress to diabetes during their lifetime.

The authors of a new study published by the Journal of the American Pharmacists Association suggest that patients with prediabetes should be prescribed metformin to prevent progression to diabetes.

Metformin is an inexpensive drug commonly used to control blood glucose levels in patients with diabetes; however, it is currently being used by less than 1% of patients with prediabetes, highlighting an opportunity to prevent disease progression.

“The data are clear. Metformin is underused and that represents a missed opportunity in addressing the diabetes epidemic, and as we reaffirmed, to reduce healthcare cost,” said lead study author Nick Carris, PharmD.

The authors found that prescribing metformin as a preventive therapy for patients with prediabetes would save $20 per patient annually. While the per-patient cost seems relatively low, it would save $820 million in healthcare costs each year, according to the study.

The authors suggest that metformin should be recommended to patients with prediabetes, since its affordability greatly offsets the cost of monitoring for progression. Additionally, it may prevent or delay patients from developing diabetes, which then mitigates comorbidities and additional healthcare costs.

Although lifestyle intervention is the most effective way to prevent diabetes, many patients have trouble committing or do not have the necessary resources to eat a healthy diet and engage in exercise, according to the authors.

For these reasons, the investigators recommend that the 41 million patients with diabetes 60 years and younger should be prescribed metformin. The authors report that this would reduce diabetes diagnoses by 20%.

Additional studies are needed to determine which patients should receive metformin as a preventive treatment.

“The next step is figuring out systematic ways of starting metformin safely, in right the patients, and without increasing other healthcare costs,” Carris concluded.