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. 2022 Dec;13(11-12):1875-1890.
doi: 10.1007/s13300-022-01324-x. Epub 2022 Oct 19.

Cost-Effectiveness of a Real-Time Continuous Glucose Monitoring System Versus Self-Monitoring of Blood Glucose in People with Type 2 Diabetes on Insulin Therapy in the UK

John J Isitt  1 , Stéphane Roze  2 , Helen Sharland  3 , Greg Cogswell  4 , Hamza Alshannaq  4   5 , Gregory J Norman  4 , Peter M Lynch  4
Affiliations

Cost-Effectiveness of a Real-Time Continuous Glucose Monitoring System Versus Self-Monitoring of Blood Glucose in People with Type 2 Diabetes on Insulin Therapy in the UK

John J Isitt et al. Diabetes Ther. 2022 Dec.

Abstract

Introduction: Real-time continuous glucose monitoring (rt-CGM) involves the measurement and display of glucose concentrations, potentially improving glucose control among insulin-treated patients with type 2 diabetes (T2D). The present analysis aimed to conduct a cost-effectiveness analysis of rt-CGM versus self-monitoring of blood glucose (SMBG) based on a USA retrospective cohort study in insulin-treated people with T2D adapted to the UK.

Methods: Long-term costs and clinical outcomes were estimated using the CORE Diabetes Model, with clinical input data sourced from a retrospective cohort study. Patients were assumed to have a baseline glycated hemoglobin (HbA1c) of 8.3%. Patients using rt-CGM were assumed to have a 0.56% reduction in HbA1c based on the mean difference between groups after 12 months of follow-up. Reduced fingerstick testing when using rt-CGM was associated with a quality of life (QoL) benefit. The analysis was performed over a lifetime time horizon from a National Health Service (NHS) perspective, including only direct costs from published data. Future costs and clinical outcomes were discounted at 3.5% per annum. Extensive sensitivity analyses were performed.

Results: Projections showed that rt-CGM was associated with increased quality-adjusted life expectancy of 0.731 quality-adjusted life years (QALYs) and increased mean total lifetime costs of Great British pounds (GBP) 2694, and an incremental cost-effectiveness ratio of GBP 3684 per QALY compared with SMBG. Key drivers of outcomes included HbA1c reduction and reduced fingerstick testing QoL benefit.

Conclusions: Over patient lifetimes, rt-CGM was associated with improved clinical outcomes and is highly likely to be cost effective versus SMBG in people with T2D on insulin therapy in the UK.

Keywords: Cost effectiveness; Health economics; Insulin-treated T2D; Real-time continuous glucose monitoring; Type 2 diabetes; UK.

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References

    1. American Diabetes Association 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S15–S33. - PubMed
    1. Whicher CA, O'Neill S, Holt RIG. Diabetes in the UK: 2019. Diabet Med. 2020;37(2):242–247. doi: 10.1111/dme.14225. - DOI - PubMed
    1. Hex N, Bartlett C, Wright D, Taylor M, Varley D. Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabet Med. 2012;29(7):855–862. - PubMed
    1. Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, Rossing P, Tsapas A, Wexler DJ, Buse JB. Management of hyperglycemia in type 2 diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) Diabetes Care. 2018;41(12):2669–2701. - PMC - PubMed
    1. Whyte MB, Hinton W, McGovern A, van Vlymen J, Ferreira F, Calderara S, Mount J, Munro N, de Lusignan S. Disparities in glycaemic control, monitoring, and treatment of type 2 diabetes in England: a retrospective cohort analysis. PLoS Med. 2019;16(10):e1002942. - PMC - PubMed