Metformin: where the agencies disagree
This page collects every recorded health technology assessment decision for one molecule across the agencies in our archive, and compares them. The comparison is the point: each agency publishes its own verdict, none publishes how that verdict sits against the others.
What the record shows
HAS (France) and TLV (Sweden) recommended or restricted metformin, while AWMSG (Wales) did not recommend it.
The file has been open for more than a decade: 19.9 years separate the first record, 7 Mar 2005 at SMC (Scotland), from the most recent, 26 Feb 2025 at CIPM (Spain).
SMC (Scotland) changed its position: not recommended on 7 Mar 2005, restricted by 12 Oct 2009, after a resubmission.
No assessment is on file from PBAC (Australia), PHARMAC (New Zealand) and G-BA (Germany), each among the eight highest-volume agencies here.
Not every gap is a refusal: for metformin, 1 submission was never made and 2 were withdrawn or terminated before a decision — an outcome set by the company rather than the assessor.
The file is active: 2 of 13 records date from 2023 or later.
3 distinct indication wordings are recorded for metformin by the agencies that label one in English (AWMSG and SMC).
SMC (Scotland) was first to assess metformin, on 7 Mar 2005; CIPM (Spain) did not open a file until 13 Apr 2023 — an unusually long tail of 18.1 years between the earliest and latest system to look at it.
The record arrives in waves: 3 separate years each carry two or more decisions, spread across 9 years in total.
3 of the 5 agencies here assessed metformin more than once, HAS (France) most often at 5 entries — repeat review is the norm for this molecule rather than the exception.
Coverage is narrow: only 5 of the 18 agencies here have assessed metformin.
The full ledger for metformin reads 5 recommended, 3 not recommended, 2 withdrawn and 1 other, with 2 in other categories.
Decisions on file
| Agency | Date | Indication as recorded | Outcome | Source |
|---|---|---|---|---|
| CIPM (Spain) | 26 Feb 2025 | Indicaciones terapéuticas autorizadas: Tratamiento de la diabetes mellitus tipo 2, especialmente en pacientes con sobrep… | excluded from SNS provision · art. 92 e | source |
| HAS (France) | 9 Feb 2022 | Listing (Transparency Committee) | SMR substantial · ASMR V | source |
| SMC (Scotland) | 15 Jan 2018 | Reduction in the risk or delay of the onset of type 2 diabetes mellitus in adult, overweight patients with impaired glucose tolerance and/or impaired fasting glucose, and… | not recommended | source |
| AWMSG (Wales) | 17 Oct 2017 | For the reduction in the risk or delay of the onset of type 2 diabetes mellitus in adult, overweight patients with IGT a… | not endorsed (non-submission) | source |
| TLV (Sweden) | 27 Feb 2015 | Metformin AB Unimedic ingår i högkostnadsskyddet | general subsidy | source |
8 further decisions for metformin, across 3 agencies, are not shown here. They link to 7 further source documents.
Related molecules
- tirzepatide — divergent outcome (recommended vs not recommended) on a shared indication
- exenatide — divergent outcome (recommended vs not recommended) on a shared indication
- empagliflozin — same ATC class A10B — Diabetes
- dapagliflozin — same ATC class A10B — Diabetes
- semaglutide — same ATC class A10B — Diabetes
- metformin / sitagliptin — same ATC class A10B — Diabetes
Coverage: 13 decisions for metformin from 5 agencies, 2005 to 2025. Data to 7 Sep 2026. ATC class A10B — Diabetes. How this page is produced. Compiled by Altima Partners; queries: sales@altimapartners.co.uk.