Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose in people with insulin-treated Type II diabetes in France
Aim: Clinical trials and real-world data for Type II diabetes both show that glycated hemoglobin (HbA1c) levels and hypoglycemia occurrence can be reduced by real-time continuous glucose monitoring (rt-CGM) versus self-monitoring of blood glucose (SMBG). The present cost-utility study investigated t...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Becaris Publishing Limited
2024-01-01
|
| Series: | Journal of Comparative Effectiveness Research |
| Subjects: |
| _version_ | 1797258438662684672 |
|---|---|
| author | Hamza Alshannaq Richard F Pollock Michael Joubert Waqas Ahmed Gregory J Norman Peter M Lync Stephane Roze |
| author_facet | Hamza Alshannaq Richard F Pollock Michael Joubert Waqas Ahmed Gregory J Norman Peter M Lync Stephane Roze |
| author_sort | Hamza Alshannaq |
| collection | DOAJ |
| description | Aim: Clinical trials and real-world data for Type II diabetes both show that glycated hemoglobin (HbA1c) levels and hypoglycemia occurrence can be reduced by real-time continuous glucose monitoring (rt-CGM) versus self-monitoring of blood glucose (SMBG). The present cost-utility study investigated the long-term health economic outcomes associated with using rt-CGM versus SMBG in people with insulin-treated Type II diabetes in France. Materials & methods: Effectiveness data were obtained from a real-world study, which showed rt-CGM reduced HbA1c by 0.56% (6.1 mmol/mol) versus sustained SMBG. Analyses were conducted using the IQVIA Core Diabetes Model. A French payer perspective was adopted over a lifetime horizon for a cohort aged 64.5 years with baseline HbA1c of 8.3% (67 mmol/mol). A willingness-to-pay threshold of €147,093 was used, and future costs and outcomes were discounted at 4% annually. Results: The analysis projected quality-adjusted life expectancy was 8.50 quality-adjusted life years (QALYs) for rt-CGM versus 8.03 QALYs for SMBG (difference: 0.47 QALYs), while total mean lifetime costs were €93,978 for rt-CGM versus €82,834 for SMBG (difference: €11,144). This yielded an incremental cost-utility ratio (ICUR) of €23,772 per QALY gained for rt-CGM versus SMBG. Results were particularly sensitive to changes in the treatment effect (i.e., change in HbA1c), annual price and quality of life benefit associated with rt-CGM, SMBG frequency, baseline patient age and complication costs. Conclusion: The use of rt-CGM is likely to be cost-effective versus SMBG for people with insulin-treated Type II diabetes in France. |
| first_indexed | 2024-04-24T22:53:32Z |
| format | Article |
| id | doaj.art-45eb70a930bd4d01ad840bdd7efc486a |
| institution | Directory Open Access Journal |
| issn | 2042-6313 |
| language | English |
| last_indexed | 2024-04-24T22:53:32Z |
| publishDate | 2024-01-01 |
| publisher | Becaris Publishing Limited |
| record_format | Article |
| series | Journal of Comparative Effectiveness Research |
| spelling | doaj.art-45eb70a930bd4d01ad840bdd7efc486a2024-03-18T09:48:30ZengBecaris Publishing LimitedJournal of Comparative Effectiveness Research2042-63132024-01-0113310.57264/cer-2023-0174Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose in people with insulin-treated Type II diabetes in FranceHamza Alshannaq0https://orcid.org/0000-0003-3952-1113Richard F Pollock1https://orcid.org/0000-0002-9873-7507Michael Joubert2https://orcid.org/0000-0002-8731-7355Waqas Ahmed3https://orcid.org/0000-0002-9035-7614Gregory J Norman4https://orcid.org/0000-0001-7989-9597Peter M Lync5Stephane Roze6Dexcom, San Diego, CA, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USACovalence Research Ltd, Harpenden, UKDiabetes Care Unit, Caen University Hospital, UNICAEN, Caen, FranceCovalence Research Ltd, Harpenden, UKDexcom, San Diego, CA, USADexcom, San Diego, CA, USAVyoo Agency, Lyon, FranceAim: Clinical trials and real-world data for Type II diabetes both show that glycated hemoglobin (HbA1c) levels and hypoglycemia occurrence can be reduced by real-time continuous glucose monitoring (rt-CGM) versus self-monitoring of blood glucose (SMBG). The present cost-utility study investigated the long-term health economic outcomes associated with using rt-CGM versus SMBG in people with insulin-treated Type II diabetes in France. Materials & methods: Effectiveness data were obtained from a real-world study, which showed rt-CGM reduced HbA1c by 0.56% (6.1 mmol/mol) versus sustained SMBG. Analyses were conducted using the IQVIA Core Diabetes Model. A French payer perspective was adopted over a lifetime horizon for a cohort aged 64.5 years with baseline HbA1c of 8.3% (67 mmol/mol). A willingness-to-pay threshold of €147,093 was used, and future costs and outcomes were discounted at 4% annually. Results: The analysis projected quality-adjusted life expectancy was 8.50 quality-adjusted life years (QALYs) for rt-CGM versus 8.03 QALYs for SMBG (difference: 0.47 QALYs), while total mean lifetime costs were €93,978 for rt-CGM versus €82,834 for SMBG (difference: €11,144). This yielded an incremental cost-utility ratio (ICUR) of €23,772 per QALY gained for rt-CGM versus SMBG. Results were particularly sensitive to changes in the treatment effect (i.e., change in HbA1c), annual price and quality of life benefit associated with rt-CGM, SMBG frequency, baseline patient age and complication costs. Conclusion: The use of rt-CGM is likely to be cost-effective versus SMBG for people with insulin-treated Type II diabetes in France.cost-utilityhealth economicsquality of lifereal-time continuous glucose monitoringtype ii diabetes |
| spellingShingle | Hamza Alshannaq Richard F Pollock Michael Joubert Waqas Ahmed Gregory J Norman Peter M Lync Stephane Roze Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose in people with insulin-treated Type II diabetes in France Journal of Comparative Effectiveness Research cost-utility health economics quality of life real-time continuous glucose monitoring type ii diabetes |
| title | Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose in people with insulin-treated Type II diabetes in France |
| title_full | Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose in people with insulin-treated Type II diabetes in France |
| title_fullStr | Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose in people with insulin-treated Type II diabetes in France |
| title_full_unstemmed | Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose in people with insulin-treated Type II diabetes in France |
| title_short | Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose in people with insulin-treated Type II diabetes in France |
| title_sort | cost utility of real time continuous glucose monitoring versus self monitoring of blood glucose in people with insulin treated type ii diabetes in france |
| topic | cost-utility health economics quality of life real-time continuous glucose monitoring type ii diabetes |
| work_keys_str_mv | AT hamzaalshannaq costutilityofrealtimecontinuousglucosemonitoringversusselfmonitoringofbloodglucoseinpeoplewithinsulintreatedtypeiidiabetesinfrance AT richardfpollock costutilityofrealtimecontinuousglucosemonitoringversusselfmonitoringofbloodglucoseinpeoplewithinsulintreatedtypeiidiabetesinfrance AT michaeljoubert costutilityofrealtimecontinuousglucosemonitoringversusselfmonitoringofbloodglucoseinpeoplewithinsulintreatedtypeiidiabetesinfrance AT waqasahmed costutilityofrealtimecontinuousglucosemonitoringversusselfmonitoringofbloodglucoseinpeoplewithinsulintreatedtypeiidiabetesinfrance AT gregoryjnorman costutilityofrealtimecontinuousglucosemonitoringversusselfmonitoringofbloodglucoseinpeoplewithinsulintreatedtypeiidiabetesinfrance AT petermlync costutilityofrealtimecontinuousglucosemonitoringversusselfmonitoringofbloodglucoseinpeoplewithinsulintreatedtypeiidiabetesinfrance AT stephaneroze costutilityofrealtimecontinuousglucosemonitoringversusselfmonitoringofbloodglucoseinpeoplewithinsulintreatedtypeiidiabetesinfrance |