Cost-Effectiveness of the FreeStyle Libre® System Versus Blood Glucose Self-Monitoring in Individuals with Type 2 Diabetes on Insulin Treatment in Sweden

Jendle, Johan; Eeg‐Olofsson, Katarina; Svensson, Johan; Franzén, Stefan; Lamotte, M; Levrat-Guillen, Fleur

doi:10.1007/s13300-021-01172-1

Cited by 18 publications

(11 citation statements)

References 28 publications

(46 reference statements)

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“…CGM has been shown to be clinically superior to SMBG at maintaining blood glucose levels within the euglycemic range [ 32 ]. Furthermore, a recent Swedish study showed long term improvements with CGM reducing HbA1c by 0.4% and it was cost-effective over the patient’s lifetime, both compared with SMBG [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Budget impact analysis of continuous glucose monitoring in individuals with type 2 diabetes on insulin treatment in England

Alsaif,

Farhat,

Blumer

et al. 2024

Health Econ Rev

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Introduction In 2022, updated guidance from NICE expanded the options for self-monitoring of blood glucose for patients with type 2 diabetes (T2DM), to include continuous glucose monitoring (CGM). In this budget impact analysis, the cost impact of CGM was compared with traditional self-monitoring of blood glucose (SMBG) in adults with T2DM over 1 year from the commissioner perspective in England. Research Design and methods The NICE-eligible T2DM cohort was split into 4 subgroups to enable nuanced costing by insulin administration frequency: basal human insulin, premixed insulin, basal-bolus insulin and bolus insulin. The model’s cost components comprised mild and severe hypoglycaemia (SH), diabetic ketoacidosis (DKA), consumables and healthcare resource utilisation in primary and secondary care. Results The introduction of CGM is estimated to be cost additive by approximately £4.6 million in the basecase, driven by increased spending on the CGM device. Overall, healthcare activity was reduced by approximately 20,000 attendances, due to fewer SH and DKA episodes in the CGM arm. General Practitioner (GP) practice-based activity is expected to drop after the first year as patients requiring CGM training is reduced. The budget impact could be neutralised if the CGM sensor was discounted by 13.2% (£29.76 to £25.83). Conclusions CGM may result in increased spending in the NICE-eligible T2DM cohort but is expected to reduce demand on secondary care services and GP time. These findings may be of interest to local decision-makers who wish to resolve the COVID-19 backlog with transformational investment in primary care to reduce secondary care activity.

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Section: Discussionmentioning

confidence: 99%

Budget impact analysis of continuous glucose monitoring in individuals with type 2 diabetes on insulin treatment in England

Alsaif,

Farhat,

Blumer

et al. 2024

Health Econ Rev

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“…4,5 The use of CGM in T2DM reduced acute diabetes complications in epidemiological studies [6][7][8][9][10] and had the potential to improve quality of life and diabetesrelated complications while reducing long-term healthcare costs. 11,12 The current clinical guidelines of the National Institute for Health and Care Excellence (NICE) recommend CGM to adults with type 2 diabetes on multiple daily insulin injections if one of the following applies: 1. They are otherwise advised to self-measure at least eight times a day 2.…”

Section: Introductionmentioning

confidence: 99%

“…The benefits of continuous glucose monitoring (CGM) in persons with type 2 diabetes (T2DM) have recently been documented in populations receiving basal insulin only, 1 basal‐bolus therapy 2,3 and even in patients not receiving insulin 4,5 . The use of CGM in T2DM reduced acute diabetes complications in epidemiological studies 6–10 and had the potential to improve quality of life and diabetes‐related complications while reducing long‐term healthcare costs 11,12 . The current clinical guidelines of the National Institute for Health and Care Excellence (NICE) recommend CGM to adults with type 2 diabetes on multiple daily insulin injections if one of the following applies: 1.…”

Section: Introductionmentioning

confidence: 99%

An estimate of the need for continuous glucose monitoring in type 2 diabetes with intensive insulin treatment in secondary healthcare

Trolle,

Christensen,

Hansen

2024

Diabet Med

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AimTo estimate the proportion of persons with type 2 diabetes (T2DM) receiving intensive insulin treatment in the secondary healthcare who could be candidates for continuous glucose monitoring (CGM), based on different HbA1c criteria. For comparison, the results are also presented as proportion of persons with type 1 diabetes (T1DM) in the same region.Patients and MethodsIn the Central Denmark Region, we identified all persons with T1DM (n = 6179) and T2DM (n = 4315) who had a minimum of one contact to a diabetes outpatient clinic from September 2021 to September 2022. Insulin regimen and HbA1c measured after a minimum of 2 months with a stable insulin regimen were retrieved from the healthcare administrative electronic platform used in the region.ResultsThe numbers of persons with T1DM and T2DM with HbA1c meeting the criteria were 5145 and 3090, respectively. The fraction of T2DM with basal‐bolus insulin was 35.3%, and the fraction with basal‐bolus insulin and HbA1c >53 (7%) mmol/mol or >58 (7.5%) mmol/mol was 20.5% and 16.6%, respectively. These proportions correspond to 19.4%, 14.4% and 11.7% of the persons with T1DM in the same geographical area.ConclusionThe proportion of persons with T2DM in secondary healthcare undergoing intensive insulin treatment who could be candidates for CGM corresponded to only a minor fraction of persons with T1DM in the same region, irrespective of any HbA1c criteria applied.

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“…While previous work demonstrated the costeffectiveness of flash monitoring in people with T2D who are managed with intensive insulin [13][14][15], those analyses were based on a single RCT, which could be a limitation on the generalizability of the results. Therefore, our aim was to further assess the cost-effectiveness of flash glucose monitoring in view of recent clinical evidence, including both interventional and observational real-world studies, and explore the use of the device in T2D individuals from the UK health system perspective.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Flash Glucose Monitoring System for People with Type 2 Diabetes Receiving Intensive Insulin Treatment

Ajjan

Bilir²,

Hellmund³

et al. 2022

Diabetes Ther

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Aims: For people with type 2 diabetes (T2D) on intensive insulin therapy, the use of flash continuous glucose monitoring (''flash monitoring'') is associated with improved average glucose control and/or reduced hypoglycemic exposure. This study assessed the cost-effectiveness of flash monitoring versus traditional blood glucose monitoring (BGM) in people with T2D using intensive insulin in the United Kingdom (UK). Methods: The IQVIA CORE Diabetes Model (IQVIA CDM; v9.0) was used to analyze the impact of flash monitoring versus BGM over a 40-year time horizon from the UK payer perspective. Model inputs included baseline characteristics, intervention effects, resource utilization, costs, and utilities, based on recently published literature and national databases. UK National Health Service reimbursed costs of flash monitoring and BGM were used. An intervention-related health utility was obtained from a time trade-off study. Alternative scenarios were explored to assess the impact of key assumptions on base case results. Results: In base-case analysis, flash monitoring compared with BGM resulted in an incremental cost of £5781 and an additional 0.47 qualityadjusted life years (QALYs). This provides an incremental cost-effectiveness ratio (ICER) of £12,309/QALY. HbA1c and the interventionrelated health utility were the key drivers of differentiation. All scenario analyses, including different discount rates, time horizons, effects on HbA1c and on the intervention-related health utility, as well as glycemic emergencies, generated ICERs of less than £20,000 per QALY. Conclusions: The consistent results across base case and a range of scenario analyses indicate that long-term flash glucose monitoring use is cost-effective compared with BGM in a UK population of T2D on intensive insulin therapy based on updated clinical effects and a cost-effectiveness threshold of £20,000-30,000 per QALY.

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Cost-Effectiveness of the FreeStyle Libre® System Versus Blood Glucose Self-Monitoring in Individuals with Type 2 Diabetes on Insulin Treatment in Sweden

Cited by 18 publications

References 28 publications

Budget impact analysis of continuous glucose monitoring in individuals with type 2 diabetes on insulin treatment in England

Budget impact analysis of continuous glucose monitoring in individuals with type 2 diabetes on insulin treatment in England

An estimate of the need for continuous glucose monitoring in type 2 diabetes with intensive insulin treatment in secondary healthcare

Cost-Effectiveness Analysis of Flash Glucose Monitoring System for People with Type 2 Diabetes Receiving Intensive Insulin Treatment

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