Type 2 diabetes mellitus (T2DM) is one of the diseases with the highest impact on health and social costs, mainly due to its chronic condition associated with its high prevalence. In particular, both the direct costs of the disease, due to hospitalizations, cost of therapy and outpatient visits, and the indirect costs, linked to the loss of productivity, complications and early mortality, are very substantial. Healthcare systems have many strategies for reducing the cost of T2DM, centered on the use of cost-effectiveness analysis, to determine the most cost-effective treatment regimens. The available literature shows how the use of sodium glucose cotransporter 2 inhibitors (SGLT2-i) to replace sulfonylureas, due to the clinical efficacy and safety profile and the positive impact on disease progression, can optimize the healthcare expenditure of the NHS for the management of T2DM in Italy.

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Key words: Type 2 diabetes mellitus, direct and indirect costs, cost-effective treatment regimen, sodium glucose cotransporter 2 inhibitors