Cost-Utility of Real-Time Continuous Glucose Monitoring versus Self-Monitoring of Blood Glucose in People with Insulin-Treated Type 2 Diabetes in Spain

被引:0
作者
Merino-Torres, Juan Francisco [1 ]
Ilham, Sabrina [2 ]
Alshannaq, Hamza [2 ,3 ]
Pollock, Richard F. [4 ]
Ahmed, Waqas [4 ]
Norman, Gregory [2 ]
机构
[1] Univ Valencia, Univ Hosp La Fe, Hlth Res Inst Fe, Endocrinol & Nutr Dept,Dept Med, Valencia, Spain
[2] Dexcom, San Diego, CA USA
[3] Univ Cincinnati, Coll Med, Cincinnati, OH USA
[4] Covalence Res Ltd, Harpenden AL5 2JD, England
来源
CLINICOECONOMICS AND OUTCOMES RESEARCH | 2024年 / 16卷
关键词
continuous glucose monitoring; CGM; cost-effectiveness; hypoglycaemia; health economics; type; 2; diabetes; LIFETIME HEALTH OUTCOMES; MELLITUS; MODEL; HYPOGLYCEMIA; VALIDATION; MANAGEMENT; FREQUENCY; CHILDREN; TRENDS; ADULTS;
D O I
10.2147/CEOR.S483459
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: Management of advanced type 2 diabetes (T2D) typically involves daily insulin therapy alongside frequent blood glucose monitoring, as treatments such as oral antidiabetic agents are therapeutically insufficient. Real-time continuous glucose monitoring (rtCGM) has been shown to facilitate greater reductions in glycated hemoglobin (HbA1c) levels and improvements in patient satisfaction relative to self-monitoring of blood glucose (SMBG). This study aimed to investigate the cost-utility of rt-CGM versus SMBG in Spanish patients with insulin-treated T2D.. Methods: The analysis was conducted using the IQVIA Core Diabetes Model (CDM V9.5). Baseline characteristics of the simulated patient cohort and treatment efficacy data were sourced from a large-scale, United States-based retrospective cohort study. Costs were obtained from Spanish sources and inflated to 2022 Euros (EUR) where required. A remaining lifetime horizon (maximum 50 years) was used, alongside an annual discount rate of 3% for future costs and health effects. A willingness-to-pay (WTP) threshold of EUR 30,000 per quality-adjusted life year (QALY) was adopted, based on precedent across previous cost-effectiveness studies set in Spain. A Spanish payer perspective was adopted. Results: Over patient lifetimes, rt-CGM yielded 9.933 QALYs, versus 8.997 QALYs with SMBG, corresponding to a 0.937 QALY gain with rt-CGM. Total costs in the rt-CGM arm were EUR 2347 higher with rt-CGM versus SMBG (EUR 125,365 versus EUR 123,017). The base case incremental cost-utility ratio was therefore EUR 2506 per QALY gained, substantially lower than the WTP threshold of EUR 30,000 per QALY. The analysis also projected a reduction in cumulative incidence of ophthalmic, renal, neurological, and cardiovascular events in rt-CGM users, with reductions of 16.03%, 13.07%, 7.34%, and 9.09%, respectively. Conclusion: Compared to SMBG, rt-CGM is highly likely to be a cost-effective intervention for patients living with insulin-treated T2D in Spain.
引用
收藏
页码:785 / 797
页数:13
相关论文
共 67 条
[61]   Is the frequency of self-monitoring of blood glucose related to long-term metabolic control?: Multicenter analysis including 24,500 patients from 191 centers in Germany and Austria [J].
Schuett, M. ;
Kern, W. ;
Krause, U. ;
Busch, P. ;
Dapp, A. ;
Grziwotz, R. ;
Mayer, I. ;
Rosenbauer, J. ;
Wagner, C. ;
Zimmermann, A. ;
Kerner, W. ;
Holl, R. W. .
EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES, 2006, 114 (07) :384-388
[62]   Glycemic Outcomes in Adults With T1D Are Impacted More by Continuous Glucose Monitoring Than by Insulin Delivery Method: 3 Years of Follow-Up From the COMISAIR Study [J].
Soupal, Jan ;
Petruzelkova, Lenka ;
Grunberger, George ;
Haskova, Aneta ;
Flekac, Milan ;
Matoulek, Martin ;
Mikes, Ondrej ;
Pelcl, Tomas ;
Skrha, Jan, Jr. ;
Horova, Eva ;
Skrha, Jan ;
Parkin, Christopher G. ;
Svacina, Stepan ;
Prazny, Martin .
DIABETES CARE, 2020, 43 (01) :37-43
[63]  
Tenny S, 2023, STATPEARLS
[64]   Estimating a cost-effectiveness threshold for the Spanish NHS [J].
Vallejo-Torres, Laura ;
Garcia-Lorenzo, Borja ;
Serrano-Aguilar, Pedro .
HEALTH ECONOMICS, 2018, 27 (04) :746-761
[65]   Hypoglycaemia in patients with type 2 diabetes treated with a combination of metformin and sulphonylurea therapy in France [J].
Vexiau, P. ;
Mavros, P. ;
Krishnarajah, G. ;
Lyu, R. ;
Yin, D. .
DIABETES OBESITY & METABOLISM, 2008, 10 :16-24
[66]   Effect of switching from intermittently scanned to real-time continuous glucose monitoring in adults with type 1 diabetes: 24-month results from the randomised ALERTT1 trial [J].
Visser, Margaretha M. ;
Charleer, Sara ;
Fieuws, Steffen ;
De Block, Christophe ;
Hilbrands, Robert ;
Van Huffel, Liesbeth ;
Maes, Toon ;
Vanhaverbeke, Gerd ;
Dirinck, Eveline ;
Myngheer, Nele ;
Vercammen, Chris ;
Nobels, Frank ;
Keymeulen, Bart ;
Mathieu, Chantal ;
Gillard, Pieter .
LANCET DIABETES & ENDOCRINOLOGY, 2023, 11 (02) :96-108
[67]   Cost-Effectiveness of Flash Glucose Monitoring for the Management of Patients with Type 1 and Patients with Type 2 Diabetes in China [J].
Zhao, Xinran ;
Ming, Jian ;
Qu, Shuli ;
Li, Hsing Jung ;
Wu, Jing ;
Ji, Linong ;
Chen, Yingyao .
DIABETES THERAPY, 2021, 12 (12) :3079-3092