COST OFFSET ANALYSIS (COA) COMPARING REAL-TIME CONTINUOUS GLUCOSE MONITORING (RT-CGM) WITH SELF-MONITORING OF BLOOD GLUCOSE (SMBG) IN PEOPLE WITH TYPE 1 DIABETES IN EIGHT COUNTRIES

Session Name
E-POSTER DISCUSSION 12
Session Type
E-POSTER DISCUSSION
Date
21.02.2020, Friday
Session Time
10:05 - 10:25
Channel
Station 6 (E-Poster Area)
Lecture Time
10:10 - 10:15
Presenter
  • John J. Isitt, United States of America
Authors
  • Michael E. Minshall, United States of America
  • John J. Isitt, United States of America
  • David Price, United States of America
  • Claudia Graham, United States of America
  • Peter Lynch, United States of America

Abstract

Background and Aims

A COA was performed comparing clinical cost offsets for an rt-CGM system with SMBG calibration compared with SMBG alone in people with T1D (n=2,000 per country) and uncontrolled glycemia, in eight countries over a one-year period.

Methods

Clinical effects for HbA1c reduction from rt-CGM and SMBG were -1.0% and -0.4%, respectively, taken from a recently published RCT (Beck, 2017). HbA1c reductions for rt-CGM and SMBG were converted into an economic benefit based on a US study (Wagner, 2001), adjusted for the Organization for Economic Cooperation and Development (OECD) healthcare purchasing power parity and 2019 exchange rates for non-US countries. Reduced hospitalization rates for severe hypoglycemia (SH; -73%) and diabetic ketoacidosis (DKA; -80%) were taken from a recent observational study in Belgium where SMBG was used in the year prior to countrywide reimbursement of rt-CGM and followed for one year (Charleer, 2018). Costs attributable to HbA1c reduction, SH and DKA hospitalizations were taken from country-specific published literature and inflated to 2019 values.

Results

The reduction in SH hospitalization rate using rt-CGM over SMBG yielded an annual 491 fewer SH hospitalizations per country. The reduction in DKA hospitalization rate using rt-CGM over SMBG yielded an annual 201 fewer DKA hospitalizations per country. Projected annual cost offsets per person with T1D using rt-CGM over SMBG are as follows: Australia, $1,216-$1,435; Canada, $1,195-$1,404; France, €953-€1,096; Germany, €911-€1,079; Italy, €960-€1,064; Spain, €722-€821; UK, £605-£720; USA, $1,535-$1,867.

Conclusions

Our modelling study demonstrates potential clinical and economic benefits for rt-CGM compared with SMBG in people with T1D from eight countries.

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