Conducting a cost consequences analysis of the DIABEO system with or without telemonitoring service to improve glycaemic control in patients with diabetes poorly controlled with a basal-bolus insulin regimen.
TELESAGE was a multicenter, double-randomized, open-label trial comparing a control group (arm 1) vs two DIABEO systems: a software alone (arm 2), and software + nurse-assisted telemonitoring and teleconsultations (arm 3). The primary objective of the study was to investigate the effect on HbA1c changes after 12-months. Both data on the diabetes management and utility data were collected throughout the study and valuated according official guidelines in France in a collective perspective for the year 2016.
Cost analysis was conducted on 665 patients (221/231/213 in arms 1,2,3 respectively). Average yearly direct diabetes management costs were €3,109, €2,404, €1,996 in arms 1,2,3 respectively (p<0.001). Including losses of productivity average yearly costs were €4,289, €,3309, €3,126 (p<0.001). These estimates did not include the price of the DIABEO system. Costs varied according to the utilization rate of the system with lower total costs in the sub-group of patients with a daily use of the system (one or twice a day) compared to the patients with discontinuous use. Health-utilities score were not different across arms 1,2,3.
The DIABEO system especially with nurse telemonitoring reduced yearly diabetes management costs due to a shorter hospital cumulated stay. Regular use of DIABEO may result in lower yearly total diabetes management costs. Impact on quality of life require further studies.