Cost‐utility of real‐time continuous glucose monitoring versus self‐monitoring of blood glucose and intermittently scanned continuous glucose monitoring in people with type 1 diabetes receiving multiple daily insulin injections in Denmark

Abstract

Aims To determine the cost‐effectiveness of the Dexcom G6 real‐time continuous glucose monitoring (rt‐CGM) system compared with both the self‐monitoring of blood glucose (SMBG) and the Abbott FreeStyle Libre 1 and 2 intermittently scanned CGM (is‐CGM) devices in people with type 1 diabetes receiving multiple daily insulin injections in Denmark. Materials and Methods The analysis was performed using the IQVIA Core Diabetes Model, which associates rt‐CGM use with glycated haemoglobin reductions of 0.6% and 0.36% based on data from the DIAMOND and ALERTT1 trials, respectively, compared with SMBG and is‐CGM use. The analysis was performed from the payer perspective over a 50‐year time horizon; future costs and clinical outcomes were discounted at 4% per annum. Results The use of rt‐CGM was associated with an incremental gain of 1.37 quality‐adjusted life years (QALYs) versus SMBG. Total mean lifetime costs were Danish Krone (DKK) 894 535 for rt‐CGM and DKK 823 474 for SMBG, resulting in an incremental cost‐utility ratio of DKK 51 918 per QALY gained versus SMBG. Compared with is‐CGM, the use of rt‐CGM led to a gain of 0.87 QALYs and higher mean lifetime costs resulting in an incremental cost‐utility ratio of DKK 40 879 to DKK 34 367 per QALY gained. Conclusions In Denmark, the rt‐CGM was projected to be highly cost‐effective versus both SMBG and is‐CGM, based on a willingness‐to‐pay threshold of 1× per capita gross domestic product per QALY gained. These findings may help inform future policies to address regional disparities in access to rt‐CGM.