AI Article Synopsis

  • Real-time continuous glucose monitoring (rt-CGM) leads to lower glycated hemoglobin (A1c) levels and reduced hypoglycemia compared to self-monitoring of blood glucose (SMBG) for insulin-treated Type 2 diabetes patients.
  • An analysis of health and economic outcomes in Canada found that using rt-CGM resulted in higher lifetime costs (CAD 207,466) but also better quality-adjusted life expectancy (9.97 QALYs) compared to SMBG (CAD 189,863 and 9.02 QALYs, respectively).
  • The incremental cost-utility ratio (ICUR) for rt-CGM was CAD 18,523 per QALY gained, suggesting that rt-CGM is likely a

Article Abstract

Clinical trials and real-world data for Type 2 diabetes have shown that real-time continuous glucose monitoring (rt-CGM) lowers glycated hemoglobin (A1c) and reduces hypoglycemia relative to self-monitoring of blood glucose (SMBG). This analysis examined the long-term health and economic outcomes associated with using rt-CGM versus SMBG in people with insulin-treated Type 2 diabetes in Canada. Clinical data were sourced from a real-world study, in which rt-CGM reduced A1C by 0.56% versus continued SMBG. The analysis was performed using the IQVIA Core Diabetes Model, from a Canadian payer perspective over a lifetime horizon for a cohort aged 65 years with an A1C of 8.3% at baseline. Future costs and clinical outcomes were discounted at 1.5% annually. Projected total mean lifetime costs were CAD 207,466 for rt-CGM versus CAD 189,863 for SMBG (difference: CAD 17,602) and projected mean quality-adjusted life expectancy was 9.97 quality-adjusted life years (QALYs) for rt-CGM versus 9.02 QALYs for SMBG (difference: 0.95 QALYs), resulting in an incremental cost-utility ratio (ICUR) of CAD 18,523 per QALY gained for rt-CGM versus SMBG. Findings were sensitive to changes in the A1C treatment effect, annual cost and quality of life benefit associated with using rt-CGM, SMBG frequency, and baseline age, but ICURs remained below CAD 50,000 per QALY in all analyses. For people in Canada with insulin-treated Type 2 diabetes and poor glycemic control, use of rt-CGM is likely to be cost-effective relative to SMBG.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10690435PMC
http://dx.doi.org/10.57264/cer-2023-0075DOI Listing

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