Journal article
The Cost-Effectiveness of Continuous Glucose Monitoring in Type 1 Diabetes
Diabetes care, Vol.33(6), pp.1269-1274
2010
DOI: 10.2337/dc09-2042
PMCID: PMC2875436
PMID: 20332354
Abstract
Objective: Continuous glucose monitoring (CGM) has been found to improve glucose control in type 1 diabetic patients. We estimated the cost-effectiveness of CGM versus standard glucose monitoring in type 1 diabetes. RESEARCH DESIGN AND METHODS This societal cost-effectiveness analysis (CEA) was conducted in trial populations in which CGM has produced a significant glycemic benefit (A1C >or=7.0% in a cohort of adults aged >or=25 years and A1C <7.0% in a cohort of all ages). Trial data were integrated into a simulation model of type 1 diabetes complications. The main outcome was the cost per quality-adjusted life-year (QALY) gained.
Results: During the trials, CGM patients experienced an immediate quality-of-life benefit (A1C >or=7.0% cohort: 0.70 quality-adjusted life-weeks [QALWs], P = 0.49; A1C <7.0% cohort: 1.39 QALWs, P = 0.04) and improved glucose control. In the long-term, CEA for the A1C >or=7.0% cohort, CGM was projected to reduce the lifetime probability of microvascular complications; the average gain in QALYs was 0.60. The incremental cost-effectiveness ratio (ICER) was $98,679/QALY (95% CI -60,000 [fourth quadrant] to -87,000 [second quadrant]). For the A1C <7.0% cohort, the average gain in QALYs was 1.11. The ICER was $78,943/QALY (15,000 [first quadrant] to -291,000 [second quadrant]). If the benefit of CGM had been limited to the long-term effects of improved glucose control, the ICER would exceed $700,000/QALY. If test strip use had been two per day with CGM long term the ICER for CGM would improve significantly.
Conclusions: Long-term projections indicate that CGM is cost-effective among type 1 diabetic patients at the $100,000/QALY threshold, although considerable uncertainty surrounds these estimates.
Details
- Title: Subtitle
- The Cost-Effectiveness of Continuous Glucose Monitoring in Type 1 Diabetes
- Creators
- Elbert S HUANG - Section of General Internal Medicine, University of Chicago, United StatesMichael O'GRADY - National Opinion Research Center, United StatesStuart WEINZIMER - Department of Pediatrics, Yale University, United StatesTim WYSOCKI - Division of Psychology and Psychiatry, Nemours Children's Clinic, United StatesAnirban BASU - Section of Hospital Medicine, University of Chicago, United StatesAaron WINN - Institute for Quantitative Social Science, Harvard University, United StatesPriya JOHN - Section of General Internal Medicine, University of Chicago, United StatesJoyce LEE - Division of Pediatric Endocrinology, University of Michigan, United StatesDavid MELTZER - Section of Hospital Medicine, University of Chicago, United StatesCraig KOLLMAN - Jaeb Center for Health Research, United StatesLori LAFFEL - Pediatric, Adolescent and Young Adult Section Joslin Diabetes Center, United StatesWilliam TAMBORLANE - Department of Pediatrics, Yale University, United StatesJuvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group (Institution)
- Contributors
- Eva Tsalikian (Contributor) - University of Iowa, Stead Family Department of Pediatrics
- Resource Type
- Journal article
- Publication Details
- Diabetes care, Vol.33(6), pp.1269-1274
- Publisher
- American Diabetes Association
- DOI
- 10.2337/dc09-2042
- PMID
- 20332354
- PMCID
- PMC2875436
- ISSN
- 0149-5992
- eISSN
- 1935-5548
- Language
- English
- Date published
- 2010
- Academic Unit
- Stead Family Department of Pediatrics
- Record Identifier
- 9984093221202771
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