PDB12 ESTIMATING THE REDUCTION IN LONG TERM COMPLICATION AND COSTS OF COMPLICATIONS IN TYPE 1 DIABETES BY REDUCED A1C LEVELS DUE TO MORE FREQUENT BLOOD GLUCOSE MONITORING

Objective 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. Methods 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. Results 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. Conclusions 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.

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789-P: Self-Care for Blood Glucose Monitoring (BGM) in Teens with Type 1 Diabetes (T1D): Impact of Real-Time Positive and Negative Affect

Diabetes ◽

10.2337/db20-789-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 789-P

Author(s):

AMIT SHAPIRA ◽

LISA K. VOLKENING ◽

JOSHUA BORUS ◽

LORI M. LAFFEL

Keyword(s):

Type 1 Diabetes ◽

Blood Glucose ◽

Negative Affect ◽

Real Time ◽

Glucose Monitoring ◽

Self Care ◽

Blood Glucose Monitoring ◽

Positive And Negative Affect

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Healthcare Utilization, Costs, and Adverse Events of Real-Time Continuous Glucose Monitoring (rtCGM) versus Traditional Blood Glucose Monitoring (BG) among US Adults with Type 1 Diabetes

Journal of Diabetes Science and Technology ◽

10.1177/19322968211031519 ◽

2021 ◽

pp. 193229682110315

Author(s):

Benjamin Wong ◽

Yalin Deng ◽

Karen L. Rascati

Keyword(s):

Type 1 Diabetes ◽

Blood Glucose ◽

Adverse Events ◽

Real Time ◽

Healthcare Utilization ◽

Continuous Glucose Monitoring ◽

Glucose Monitoring ◽

Medical Costs ◽

Blood Glucose Monitoring

Objective: To compare healthcare utilization, costs, and incidence of diabetes-specific adverse events (ie, hyperglycemia, diabetic ketoacidosis, and hypoglycemia) in type 1 diabetes adult patients using real-time continuous glucose monitoring (rtCGM) versus traditional blood glucose monitoring (BG). Methods: Adult patients (≥18 years old) with type 1 diabetes in a large national administrative claims database between 2013 and 2015 were identified. rtCGM patients with 6-month continuous health plan enrollment and ≥1 pharmacy claim for insulin during pre-index and post-index periods were propensity-score matched with BG patients. Healthcare utilization associated with diabetic adverse events were examined. A difference-in-difference (DID) method was used to compare the change in costs between rtCGM and BG cohorts. Results: Six-month medical costs for rtCGM patients ( N = 153) increased from pre- to post-index period, while they decreased for matched BG patients ( N = 153). DID analysis indicated a $2,807 ( P = .062) higher post-index difference in total medical costs for rtCGM patients. Pharmacy costs for both cohorts increased. DID analysis indicated a $1,775 ( P < .001) higher post-index difference in pharmacy costs for rtCGM patients. The incidence of hyperglycemia for both cohorts increased minimally from pre- to post-index period. The incidence of hypoglycemia for rtCGM patients decreased, while it increased marginally for BG patients. Inpatient hospitalizations for rtCGM and BG patients increased and decreased marginally, respectively. Conclusions: rtCGM users had non-significantly higher pre-post differences in medical costs but significantly higher pre-post differences in pharmacy costs (mostly due to the rtCGM costs themselves) compared to BG users. Changes in adverse events were minimal.

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