Cost-effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetes

<p>Abstract</p> <p>Background</p> <p>Our objective was to determine the cost-effectiveness of Continuous Glucose Monitoring (CGM) technology with intensive insulin therapy compared to self-monitoring of blood glucose (SMBG) in adults with type 1 diabetes in the United S...

Full description

Bibliographic Details
Main Authors: Nair Kavita V, Campbell Jonathan D, Ellis Samuel L, McQueen R Brett, Sullivan Patrick W
Format: Article
Language:English
Published: BMC 2011-09-01
Series:Cost Effectiveness and Resource Allocation
Subjects:
Online Access:http://www.resource-allocation.com/content/9/1/13
_version_ 1818083039397281792
author Nair Kavita V
Campbell Jonathan D
Ellis Samuel L
McQueen R Brett
Sullivan Patrick W
author_facet Nair Kavita V
Campbell Jonathan D
Ellis Samuel L
McQueen R Brett
Sullivan Patrick W
author_sort Nair Kavita V
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Our objective was to determine the cost-effectiveness of Continuous Glucose Monitoring (CGM) technology with intensive insulin therapy compared to self-monitoring of blood glucose (SMBG) in adults with type 1 diabetes in the United States.</p> <p>Methods</p> <p>A Markov cohort analysis was used to model the long-term disease progression of 12 different diabetes disease states, using a cycle length of 1 year with a 33-year time horizon. The analysis uses a societal perspective to model a population with a 20-year history of diabetes with mean age of 40. Costs are expressed in $US 2007, effectiveness in quality-adjusted life years (QALYs). Parameter estimates and their ranges were derived from the literature. Utility estimates were drawn from the EQ-5D catalogue. Probabilities were derived from the Diabetes Control and Complications Trial (DCCT), the United Kingdom Prospective Diabetes Study (UKPDS), and the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Costs and QALYs were discounted at 3% per year. Univariate and Multivariate probabilistic sensitivity analyses were conducted using 10,000 Monte Carlo simulations.</p> <p>Results</p> <p>Compared to SMBG, use of CGM with intensive insulin treatment resulted in an expected improvement in effectiveness of 0.52 QALYs, and an expected increase in cost of $23,552, resulting in an ICER of approximately $45,033/QALY. For a willingness-to-pay (WTP) of $100,000/QALY, CGM with intensive insulin therapy was cost-effective in 70% of the Monte Carlo simulations.</p> <p>Conclusions</p> <p>CGM with intensive insulin therapy appears to be cost-effective relative to SMBG and other societal health interventions.</p>
first_indexed 2024-12-10T19:31:39Z
format Article
id doaj.art-72fd75fc68e94265b2eb0845e1a20cb4
institution Directory Open Access Journal
issn 1478-7547
language English
last_indexed 2024-12-10T19:31:39Z
publishDate 2011-09-01
publisher BMC
record_format Article
series Cost Effectiveness and Resource Allocation
spelling doaj.art-72fd75fc68e94265b2eb0845e1a20cb42022-12-22T01:36:14ZengBMCCost Effectiveness and Resource Allocation1478-75472011-09-01911310.1186/1478-7547-9-13Cost-effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetesNair Kavita VCampbell Jonathan DEllis Samuel LMcQueen R BrettSullivan Patrick W<p>Abstract</p> <p>Background</p> <p>Our objective was to determine the cost-effectiveness of Continuous Glucose Monitoring (CGM) technology with intensive insulin therapy compared to self-monitoring of blood glucose (SMBG) in adults with type 1 diabetes in the United States.</p> <p>Methods</p> <p>A Markov cohort analysis was used to model the long-term disease progression of 12 different diabetes disease states, using a cycle length of 1 year with a 33-year time horizon. The analysis uses a societal perspective to model a population with a 20-year history of diabetes with mean age of 40. Costs are expressed in $US 2007, effectiveness in quality-adjusted life years (QALYs). Parameter estimates and their ranges were derived from the literature. Utility estimates were drawn from the EQ-5D catalogue. Probabilities were derived from the Diabetes Control and Complications Trial (DCCT), the United Kingdom Prospective Diabetes Study (UKPDS), and the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Costs and QALYs were discounted at 3% per year. Univariate and Multivariate probabilistic sensitivity analyses were conducted using 10,000 Monte Carlo simulations.</p> <p>Results</p> <p>Compared to SMBG, use of CGM with intensive insulin treatment resulted in an expected improvement in effectiveness of 0.52 QALYs, and an expected increase in cost of $23,552, resulting in an ICER of approximately $45,033/QALY. For a willingness-to-pay (WTP) of $100,000/QALY, CGM with intensive insulin therapy was cost-effective in 70% of the Monte Carlo simulations.</p> <p>Conclusions</p> <p>CGM with intensive insulin therapy appears to be cost-effective relative to SMBG and other societal health interventions.</p>http://www.resource-allocation.com/content/9/1/13Cost-effectiveness analysisContinuous Glucose MonitoringType 1 diabetesCost-utility analysisSelf-Monitoring of Blood Glucose
spellingShingle Nair Kavita V
Campbell Jonathan D
Ellis Samuel L
McQueen R Brett
Sullivan Patrick W
Cost-effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetes
Cost Effectiveness and Resource Allocation
Cost-effectiveness analysis
Continuous Glucose Monitoring
Type 1 diabetes
Cost-utility analysis
Self-Monitoring of Blood Glucose
title Cost-effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetes
title_full Cost-effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetes
title_fullStr Cost-effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetes
title_full_unstemmed Cost-effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetes
title_short Cost-effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetes
title_sort cost effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetes
topic Cost-effectiveness analysis
Continuous Glucose Monitoring
Type 1 diabetes
Cost-utility analysis
Self-Monitoring of Blood Glucose
url http://www.resource-allocation.com/content/9/1/13
work_keys_str_mv AT nairkavitav costeffectivenessofcontinuousglucosemonitoringandintensiveinsulintherapyfortype1diabetes
AT campbelljonathand costeffectivenessofcontinuousglucosemonitoringandintensiveinsulintherapyfortype1diabetes
AT ellissamuell costeffectivenessofcontinuousglucosemonitoringandintensiveinsulintherapyfortype1diabetes
AT mcqueenrbrett costeffectivenessofcontinuousglucosemonitoringandintensiveinsulintherapyfortype1diabetes
AT sullivanpatrickw costeffectivenessofcontinuousglucosemonitoringandintensiveinsulintherapyfortype1diabetes