Cost calculation for a flash glucose monitoring system for UK adults with type 1 diabetes mellitus receiving intensive insulin treatment

Hellmund, Richard; Weitgasser, Raimund; Blissett, Deirdre B

doi:10.1016/j.diabres.2018.01.028

Cited by 32 publications

(26 citation statements)

References 20 publications

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“…Based on the assumptions of this model, the use of the FM system would cut the total annual cost per patient by €1911 (43.1%), which could generate annual savings for the Spanish National Health System of more than €2 million per cohort of 1000 treated patients. The cost savings associated with the FM system have also been observed in other settings such as the UK in patients with T1DM, 31 and also in patients with T2DM. 32 Utilization of the FM system in the population with T1DM was associated with annual savings of £234.28/patient 31 in a scenario with 10 daily SMBG measurements as a reflection of the National Institute for Health and Care Excellence recommendations regarding patients with T1DM.…”

Section: Discussionmentioning

confidence: 68%

“…The cost savings associated with the FM system have also been observed in other settings such as the UK in patients with T1DM, 31 and also in patients with T2DM. 32 Utilization of the FM system in the population with T1DM was associated with annual savings of £234.28/patient 31 in a scenario with 10 daily SMBG measurements as a reflection of the National Institute for Health and Care Excellence recommendations regarding patients with T1DM. 11…”

Section: Discussionmentioning

confidence: 68%

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Cost analysis of the flash monitoring system (FreeStyle Libre 2) in adults with type 1 diabetes mellitus

Oyagüez

Merino-Torres

Brito

et al. 2020

BMJ Open Diab Res Care

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IntroductionCompare cost of the interstitial liquid glucose flash monitoring (FM) system (FreeStyle Libre 2) versus self-monitoring of blood glucose (SMBG) in adults with type 1 diabetes mellitus (T1DM) in Spain.Research design and methodsA model was developed to estimate, with the perspective of the Spanish health system, the annual costs associated with glucose monitoring and hypoglycemic events management in T1DM population, with multiple insulin daily doses (MDI). According to published evidence, rate of severe hypoglycemia (SHE) of 4.90 episodes per patient-year was applied. Reduction of SHE (58.6%) was modeled associated with FM use. Published rates of hospital care (20.2%) and subsequent admission (16%) were assumed for SHE. The daily consumption of strips and lancets was 9 in patients with SMBG (before and after 4 daily intakes and at bedtime) and 0.5 for FM users (according to IMPACT trial findings). Annual consumption of 26 FM sensors was considered (1 every 14 days). Unit costs (in € of 2019, excluding VAT) were obtained from literature and national databases. Sensitivity analyses (SA) were carried out to evaluate the model robustness.ResultsThe total annual cost/patient was €4437 for SMBG and €2526 for FM. The use of FM would be associated with an annual savings in the costs of monitoring and managing hypoglycemic events of €1911 per patient-year. In a hypothetical cohort of 1000 patients with T1DM MDI, FM could avoid in 1 year 4900 SHE, 93 hospitalizations for SHE. In addition, the use of FM would generate total savings of up to €1 910 000 per year. In the SA with alternative hypoglycemia events rates and use of strips and lancets, and including non-SHE episodes, savings from €370 000 to €1 760 000 were observed with FM.ConclusionsThe use of the FM system to monitor glucose in adults with T1DM treated with MDI, would reduce hypoglycemic events and would result in cost savings for the health system.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 68%

Cost analysis of the flash monitoring system (FreeStyle Libre 2) in adults with type 1 diabetes mellitus

Oyagüez

Merino-Torres

Brito

et al. 2020

BMJ Open Diab Res Care

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“…Cost-calculations of CGM compared with SMBG (using either CSII or MDI) indicated a cost saving of $1025-$1458 USD over a 1-year period [27]. Flash glucose monitoring was reported to provide $474 AUD ($333 USD) cost savings over 1 year compared to SMBG and heterogeneous insulin delivery methods in the UK [28], based on the 'Novel Glucose-Sensing Technology and Hypoglycemia in Type 1 Diabetes: a Multicentre, Non-masked, Randomised Controlled Trial' (IMPACT study) [29]. A budget impact analysis in the UK reported CGM to have 'minimal budget impact' compared to SMBG when insulin delivery modality was either CSII or MDI [30].…”

Section: Resultsmentioning

confidence: 99%

Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis

et al. 2020

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Background: With the rapid development of technologies for type 1 diabetes, economic evaluations are integral in guiding cost-effective clinical and policy decisions. We therefore aimed to review and synthesise the current economic literature for available diabetes management technologies and outline key determinants of costeffectiveness. Methods: A systematic search was conducted in April 2019 that focused on modelling or trial based economic evaluations. Searched databases included Medline, Medline in-process and other non-indexed citations, EMBASE, PubMed, All Evidenced Based Medicine Reviews, EconLit, Cost-effectiveness analysis Registry, Research Papers in Economics, Web of Science, PsycInfo, CINAHL, and PROSPERO from inception. We assessed quality of included studies with the Questionnaire to Assess Relevance and Credibility of Modeling Studies for Informing Health Care Decision Making an ISPOR-AMCP-NPC good practice task force report. Screening of abstracts and full-texts, appraisal, and extraction were performed by two independent researches. Results: We identified 16,772 publications, of which 35 were analysed and included 11 health technologies. Despite a lack of consensus, most studies reported that insulin pumps (56%) or interstitial glucose sensors (62%) were costeffective, although incremental cost-effectiveness ratios ranged widely ($14,266-$2,997,832 USD). Cost-effectiveness for combined insulin pumps and glucose sensors was less clear. Determinants of cost-effectiveness included treatment effects on glycosylated haemoglobin and hypoglycaemia, costing of technologies and complications, and measures of utility. Conclusions: Insulin pumps or glucose sensors appeared cost-effective, particularly in populations with higher HbA1c levels and rates of hypoglycaemia. However, cost-effectiveness for combined insulin pumps and glucose sensors was less clear. Registration: The study was registered with PROSPERO, number CRD42017077221.

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“…When considering a high glucose test frequency, isCGM is even more economical than capillary glucose tests. 58 At the end of 2018, the second-generation FreeStyle…”

Section: Self-reported Adverse Events and Complaints With Iscgmmentioning

confidence: 99%

Intermittently scanned continuous glucose monitoring is associated with high satisfaction but increased HbA1c and weight in well‐controlled youth with type 1 diabetes

Charleer

Gillard

Vandoorne³

et al. 2020

Pediatric Diabetes

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Objective: We undertook a 24-month prospective observational single-center realworld trial to study impact of access to intermittently scanned continuous glucose monitoring (isCGM) on quality of life (QOL) and glycemic control of youth with type 1 diabetes (T1D). Methods: Between September 2016 and November 2017, 138 children and adolescents with T1D were recruited. Demographic, metabolic, and QOL data were collected during 24 months of routine follow-up. Primary endpoint was the evolution of QOL, with secondary outcomes change in HbA1c, occurrence of acute diabetes complications, and school absenteeism. Results: Ninety-two percent of participants found isCGM more user-friendly than capillary finger-stick tests and had high treatment satisfaction, without change in diabetes-specific QOL. HbA1c significantly increased from 7.2% (7.0-7.3) (55 mmol/ mol [53-56]) at baseline to 7.6% (7.4-7.8) (60 mmol/mol [57-62]) at 12 months (P < .0001) and was unchanged up to 24 months. Overall increase was mainly driven by children with baseline HbA1c <7.0% (<53 mmol/mol). Additionally, BMI adjusted for age was higher at study end. In year before isCGM, 228 days per 100 patientyears of school absenteeism were reported, which dramatically decreased to 13 days per 100 patient-years (P = .016) after 24 months. Parents of children also reported less work absenteeism (P = .011). Conclusion: The use of isCGM by T1D pediatrics is associated with high treatment satisfaction and fewer days of school absence. However, increased HbA1c and weight may reflect a looser lifestyle, with less attention to diet and more avoidance of hypoglycemia. Intensive education specifically focusing on these points may mitigate these issues.

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Cost calculation for a flash glucose monitoring system for UK adults with type 1 diabetes mellitus receiving intensive insulin treatment

Cited by 32 publications

References 20 publications

Cost analysis of the flash monitoring system (FreeStyle Libre 2) in adults with type 1 diabetes mellitus

Cost analysis of the flash monitoring system (FreeStyle Libre 2) in adults with type 1 diabetes mellitus

Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis

Intermittently scanned continuous glucose monitoring is associated with high satisfaction but increased HbA1c and weight in well‐controlled youth with type 1 diabetes

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