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Modelling potential cost savings from use of real‐time continuous glucose monitoring in pregnant women with Type 1 diabetes
Author(s) -
Murphy H. R.,
Feig D. S.,
Sanchez J. J.,
de Portu S.,
Sale A.
Publication year - 2019
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.14046
Subject(s) - medicine , pregnancy , type 1 diabetes , continuous glucose monitoring , cohort , type 2 diabetes , neonatal intensive care unit , blood glucose self monitoring , diabetes mellitus , gestation , emergency medicine , obstetrics , intensive care medicine , pediatrics , endocrinology , genetics , biology
Aim To investigate potential cost savings associated with the use of real‐time continuous glucose monitoring ( RT ‐ CGM ) throughout pregnancy in women with Type 1 diabetes. Methods A budget impact model was developed to estimate, from the perspective of National Health Service England, the total costs of managing pregnancy and delivery in women with Type 1 diabetes using self‐monitoring of blood glucose ( SMBG ) with and without RT ‐ CGM . It was assumed that the entire modelled cohort ( n = 1441) would use RT ‐ CGM from 10 to 38 weeks’ gestation (7 months). Data on pregnancy and neonatal complication rates and related costs were derived from published literature, national tariffs, and device manufacturers. Results The cost of glucose monitoring was £588 with SMBG alone and £1820 with RT ‐ CGM . The total annual costs of managing pregnancy and delivery in women with Type 1 diabetes were £23 725 648 with SMBG alone, and £14 165 187 with SMBG and RT ‐ CGM ; indicating potential cost savings of approximately £9 560 461 from using RT ‐ CGM . The principal drivers of cost savings were the daily cost of neonatal intensive care unit ( NICU ) admissions (£3743) and the shorter duration of NICU stay (mean 6.6 vs. 9.1 days respectively). Sensitivity analyses showed that RT ‐ CGM remained cost saving, albeit to lesser extents, across a range of NICU costs and durations of hospital stay, and with varying numbers of daily SMBG measurements. Conclusions Routine use of RT ‐ CGM by pregnant women with Type 1 diabetes, would result in substantial cost savings, mainly through reductions in NICU admissions and shorter duration of NICU care.