1. Cost-utility analysis of a flash continuous glucose monitoring system in the management of people with type 2 diabetes mellitus on basal insulin therapy-An Italian healthcare system perspective.
- Author
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Del Prato S, Giorgino F, Szafranski K, and Poon Y
- Subjects
- Humans, Italy, Female, Male, Middle Aged, Insulin therapeutic use, Insulin economics, Insulin administration & dosage, Blood Glucose analysis, Blood Glucose metabolism, Aged, Glycated Hemoglobin analysis, Glycated Hemoglobin metabolism, Hypoglycemia chemically induced, Hypoglycemia economics, Hypoglycemia prevention & control, Continuous Glucose Monitoring, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 economics, Cost-Benefit Analysis, Blood Glucose Self-Monitoring economics, Blood Glucose Self-Monitoring instrumentation, Blood Glucose Self-Monitoring methods, Quality-Adjusted Life Years, Hypoglycemic Agents therapeutic use, Hypoglycemic Agents economics
- Abstract
Aims: To assess the cost-utility of the FreeStyle Libre flash continuous glucose monitoring (CGM) system from an Italian healthcare system perspective, when compared with self-monitoring of blood glucose (SMBG) in people living with type 2 diabetes mellitus (T2DM) receiving basal insulin., Materials and Methods: A patient-level microsimulation model was run using Microsoft Excel for 10 000 patients over a lifetime horizon, with 3.0% discounting for costs and utilities. Inputs were based on clinical trials and real-world evidence, with patient characteristics reflecting Italian population data. The effect of flash CGM was modelled as a persistent 0.8% reduction in glycated haemoglobin versus SMBG. Costs (€ 2023) and disutilities were applied to glucose monitoring, diabetes complications, severe hypoglycaemia, and diabetic ketoacidosis. The health outcome was measured as quality-adjusted life-years (QALYs)., Results: Direct costs were €5338 higher with flash CGM than with SMBG. Flash CGM was associated with 0.51 more QALYs than SMBG, giving an incremental cost-effectiveness ratio (ICER) of €10 556/QALY. Scenario analysis ICERs ranged from €3825/QALY to €26 737/QALY. In probabilistic analysis, flash CGM was 100% likely to be cost effective at willingness-to-pay thresholds > €20 000/QALY., Conclusions: From an Italian healthcare system perspective, flash CGM is cost effective compared with SMBG for people living with T2DM on basal insulin., (© 2024 John Wiley & Sons Ltd.)
- Published
- 2024
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