The objective of this study was to assess the cost-effectiveness of retrospective CGM (rCGM) in people with type 2 diabetes (T2D).
The IQVIA CORE Diabetes model was used to perform cost-effectiveness analyses over patient lifetimes. Clinical data were sourced from the single-arm before/after ADJUST study. Type 2 patients already on insulin were equipped with a rCGM device. The use of the rCGM was associated with a reduction in HbA1c of -1.3%, from 9.4% (79 mmol/mol) at baseline to 8.1% (65 mmol/mol) at 12 months. Cost data, expressed in 2018 euros (EUR), were obtained from Portuguese reference prices and the published literature. A 5% discount rate was applied to both clinical and economic outcomes.
rCGM was associated with a quality-adjusted life-year (QALY) gain of 0.09 per patient based on their remaining life expectancy (ca 24 years) but with higher overall costs 616 EUR, due to the costs of rCGM and related visits. This led to an incremental cost-effectiveness ratio (ICER) of EUR 6,765 per QALY gained. Use of rCGM would lower the cumulative incidence of diabetes-related complications. Higher rCGM acquisition costs were partially offset by reduced complication costs. Extensive sensitivity analysis on key drivers confirmed the robustness of results.
rCGM was associated with improved glycemic control and quality of life in peoples with T2D with elevated HbA1c and already on insulin. rCGM is a cost-effective management tool for people with T2D in Portugal.