Objectives: Our aim was to systematically identify and appraise cost-effectiveness studies of metformin in prediabetic subjects.Methods: A systematic literature review was conducted and reported according to standard guidlines. The search was conducted in PubMed, Embase, International Society for Pharmacoeconomics and Outcomes Research (ISPOR) presentation database and the Cost-Effectiveness Analysis (CEA) and Center for Reviews and Dissemination (CRD) registries. All cost-effectiveness studies assessing metformin in prediabetic patients were included.Results: Twenty-three reports were included. Metformin and intensive lifestyle changes (ILC) interventions were always cost-effective compared to placebo. ILC was cost-effective and sometimes dominant compared to metformin. Metformin was cost-saving compared to ILC in the short and medium-term. Although, in the long term, metformin was more expensive than ILC in terms of direct medical costs, when indirect non-medical costs are included, metformin less expensive than ILC. One study reported that for patients with Body Mass Index (BMI) higher than 30 kg/m2, metformin is a cost-effective strategy compared to placebo and ILC. However, this finding was not confirmed by other retrieved studies.Conclusion: ILC is cost-effective compared to metformin and, both of them are cost-effective compared to placebo. Metformin may be cost-saving in the short- to medium-term and possibly in the long-term.

中文翻译：

---

二甲双胍在糖尿病前期的成本-效果：对卫生经济评估的系统文献综述。

目的：我们的目的是系统地鉴定和评估二甲双胍在糖尿病前期受试者中的成本-效果研究。方法：根据标准指南进行系统的文献综述并进行报告。该搜索是在PubMed，Embase，国际药物经济学和结果研究协会（ISPOR）演示数据库以及成本效益分析（CEA）和审查与传播中心（CRD）注册表中进行的。包括所有评估糖尿病前期患者中二甲双胍的成本-效果研究。结果：包括23篇报告。与安慰剂相比，二甲双胍和剧烈的生活方式改变（ILC）干预始终具有成本效益。与二甲双胍相比，ILC具有成本效益，有时甚至占主导地位。与ILC相比，在短期和中期，二甲双胍可以节省成本。尽管从长期来看，二甲双胍在直接医疗费用方面比ILC贵，但如果包括间接非医疗费用，二甲双胍比ILC便宜。一项研究报告称，对于体重指数（BMI）高于30 kg / m2的患者，与安慰剂和ILC相比，二甲双胍是一种具有成本效益的策略。然而，这一发现并未得到其他文献的证实。结论：与二甲双胍相比，ILC具有成本效益，与安慰剂相比，两者均具有成本效益。二甲双胍可能在短期到中期乃至长期节省成本。一项研究报告称，对于体重指数（BMI）高于30 kg / m2的患者，与安慰剂和ILC相比，二甲双胍是一种具有成本效益的策略。然而，这一发现并未得到其他文献的证实。结论：与二甲双胍相比，ILC具有成本效益，与安慰剂相比，两者均具有成本效益。二甲双胍可能在短期到中期乃至长期节省成本。一项研究报告称，对于体重指数（BMI）高于30 kg / m2的患者，与安慰剂和ILC相比，二甲双胍是一种具有成本效益的策略。然而，这一发现并未得到其他文献的证实。结论：与二甲双胍相比，ILC具有成本效益，与安慰剂相比，两者均具有成本效益。二甲双胍可能在短期到中期乃至长期节省成本。