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Health‐economic analysis of real‐time continuous glucose monitoring in people with Type 1 diabetes
Author(s) -
Roze S.,
Saunders R.,
Brandt A.S.,
Portu S.,
Papo N. L.,
Jendle J.
Publication year - 2015
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12661
Subject(s) - medicine , life expectancy , insulin pump , type 1 diabetes , diabetes mellitus , continuous glucose monitoring , cohort , type 2 diabetes , quality of life (healthcare) , quality adjusted life year , cost effectiveness , environmental health , endocrinology , population , risk analysis (engineering) , nursing
Aim To evaluate the clinical benefits and cost‐effectiveness of the sensor‐augmented pump compared with self–monitoring of plasma glucose plus continuous subcutaneous insulin infusion in people with Type 1 diabetes. Methods The CORE Diabetes Model was used to simulate disease progression in a cohort of people with baseline characteristics taken from a published meta‐analysis. Direct and indirect costs for 2010–2011 were calculated from a societal payer perspective, with cost‐effectiveness calculated over the patient's lifetime. Discount rates of 3% per annum were applied to the costs and the clinical outcomes. Results Use of the sensor‐augmented pump was associated with an increase in mean discounted, quality–adjusted life expectancy of 0.76 quality–adjusted life years compared with continuous subcutaneous insulin infusion (13.05 ± 0.12 quality–adjusted life years vs 12.29 ± 0.12 quality–adjusted life years, respectively). Undiscounted life expectancy increased by 1.03 years for the sensor‐augmented pump compared with continuous subcutaneous insulin infusion. In addition, the onset of complications was delayed (by a mean of 1.15 years) with use of the sensor‐augmented pump. This analysis resulted in an incremental cost–effectiveness ratio of 367,571 SEK per quality–adjusted life year gained with the sensor‐augmented pump. The additional treatment costs related to the use of the sensor‐augmented pump were partially offset by the savings attributable to the reduction in diabetes‐related complications and the lower frequency of self‐monitoring of plasma glucose. Conclusions Analysis using the CORE Diabetes Model showed that improvements in glycaemic control associated with sensor‐augmented pump use led to a reduced incidence of diabetes‐related complications and a longer life expectancy. Use of the sensor‐augmented pump was associated with an incremental cost–effectiveness ratio of 367,571 SEK per quality–adjusted life year gained, which is likely to represent good value for money in the treatment of Type 1 diabetes in Sweden.