<b>Objective</b>
<p>A long-term health
economic analysis was performed to establish the cost-effectiveness of real-time
continuous glucose monitoring (RT-CGM) (Dexcom G6) versus self-monitoring of
blood glucose (SMBG) alone in UK-based patients with type 1 diabetes. </p>
<p><b>Methods</b></p>
<p>The analysis utilized
the IQVIA CORE Diabetes Model. Clinical
input data were sourced from the DIAMOND trial in adults with type 1 diabetes; simulations
were performed separately in the overall population of patients with baseline HbA1c
≥7.5% (58 mmol/mol); and a secondary analysis was performed in patients
with baseline HbA1c ≥8.5% (69 mmol/mol).
The analysis was performed from the NHS healthcare payer perspective
over a lifetime time horizon. </p>
<p><b>Results</b></p>
<p>In the overall
population, G6 RT-CGM was associated with a mean incremental gain in
quality-adjusted life expectancy of 1.49 quality-adjusted life years (QALYs) versus
SMBG (mean [standard deviation; SD] 11.47 [2.04] QALYs versus 9.99 [1.84]
QALYs). Total mean (SD) lifetime costs
were also GBP 14,234 higher with RT-CGM (GBP 102,468 [35,681] versus
GBP 88,234 [39,027]) resulting in an ICER of GBP 9,558 per QALY
gained. Sensitivity analyses revealed
that the findings were sensitive to changes in the quality of life benefit
associated with reduced fear of hypoglycemia and avoidance of fingerstick
testing as well as the HbA1c benefit associated with RT-CGM use. </p>
<p><b>Conclusions</b></p>
<p>For UK-based type 1
diabetes patients, the G6 RT-CGM device is associated with significant
improvements in clinical outcomes and, over patient lifetimes, is a
cost-effective disease management option relative to SMBG, based on a
willingness-to-pay threshold of GBP 20,000 per QALY gained. </p>