Evaluation of the Long-Term Cost-Effectiveness of the Dexcom G6 Continuous Glucose Monitor versus Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in Canada
Stephane Roze,1 John J Isitt,1 Jayne Smith-Palmer,2 Peter Lynch3 1Vyoo Agency, Paris, France; 2Ossian Health Economics and Communications, Basel, Switzerland; 3Dexcom, San Diego, CA, USACorrespondence: Jayne Smith-PalmerOssian Health Economics and Communications GmbH, Bäumleingasse 20, Basel, 4051,...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2021-08-01
|
| Series: | ClinicoEconomics and Outcomes Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/evaluation-of-the-long-term-cost-effectiveness-of-the-dexcom-g6-contin-peer-reviewed-fulltext-article-CEOR |
| _version_ | 1818606955179016192 |
|---|---|
| author | Roze S Isitt JJ Smith-Palmer J Lynch P |
| author_facet | Roze S Isitt JJ Smith-Palmer J Lynch P |
| author_sort | Roze S |
| collection | DOAJ |
| description | Stephane Roze,1 John J Isitt,1 Jayne Smith-Palmer,2 Peter Lynch3 1Vyoo Agency, Paris, France; 2Ossian Health Economics and Communications, Basel, Switzerland; 3Dexcom, San Diego, CA, USACorrespondence: Jayne Smith-PalmerOssian Health Economics and Communications GmbH, Bäumleingasse 20, Basel, 4051, SwitzerlandTel +41 61 271 6214Email smith-palmer@ossianconsulting.comBackground: The Dexcom G6 real-time continuous glucose monitoring (RT-CGM) system is one of the most sophisticated RT-CGM systems developed to date and became available in Canada in 2019. A health economic analysis was performed to determine the long-term cost-effectiveness of the Dexcom G6 RT-CGM system versus SMBG in adults with type 1 diabetes (T1D) in Canada.Methods: The analysis was performed using the IQVIA Core Diabetes Model. Based on clinical trial data, patients with mean baseline HbA1c of 8.6% were assumed to have a HbA1c reduction of 1.0% with RT-CGM versus 0.4% reduction with SMBG. RT-CGM was also associated with a quality of life (QoL) benefit owing to reduced incidence of hypoglycemia, reduced fear of hypoglycemia (FoH) and elimination of fingerstick testing. Direct medical costs were sourced from published literature, and inflated to 2019 Canadian dollars (CAD).Results: Dexcom G6 RT-CGM was projected to improve mean quality-adjusted life expectancy by 2.09 quality-adjusted life years (QALYs) relative to SMBG (15.52 versus 13.43 QALYs) but mean total lifetime cots were CAD 35,353 higher with RT-CGM (CAD 227,357 versus CAD 192,004) resulting in an incremental cost-effectiveness ratio (ICER) of CAD 16,931 per QALY gained. Sensitivity analyses revealed that assumptions relating to the QoL benefit associated with reduced FoH and the elimination of fingerstick testing with RT-CGM as well as SMBG usage and change in HbA1c were the key drivers of cost-effectiveness.Conclusion: For adults with T1D in Canada, RT-CGM is associated with improved glycemic control and QoL benefits owing to a reduced FoH and elimination of the requirement for fingerstick testing and over a lifetime time horizon is cost-effective relative to SMBG.Keywords: type 1 diabetes, Canada, real-time continuous glucose monitoring, cost-effectiveness |
| first_indexed | 2024-12-16T14:19:04Z |
| format | Article |
| id | doaj.art-9db270063c094f13bedcc94bef5962b9 |
| institution | Directory Open Access Journal |
| issn | 1178-6981 |
| language | English |
| last_indexed | 2024-12-16T14:19:04Z |
| publishDate | 2021-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | ClinicoEconomics and Outcomes Research |
| spelling | doaj.art-9db270063c094f13bedcc94bef5962b92022-12-21T22:28:34ZengDove Medical PressClinicoEconomics and Outcomes Research1178-69812021-08-01Volume 1371772567749Evaluation of the Long-Term Cost-Effectiveness of the Dexcom G6 Continuous Glucose Monitor versus Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in CanadaRoze SIsitt JJSmith-Palmer JLynch PStephane Roze,1 John J Isitt,1 Jayne Smith-Palmer,2 Peter Lynch3 1Vyoo Agency, Paris, France; 2Ossian Health Economics and Communications, Basel, Switzerland; 3Dexcom, San Diego, CA, USACorrespondence: Jayne Smith-PalmerOssian Health Economics and Communications GmbH, Bäumleingasse 20, Basel, 4051, SwitzerlandTel +41 61 271 6214Email smith-palmer@ossianconsulting.comBackground: The Dexcom G6 real-time continuous glucose monitoring (RT-CGM) system is one of the most sophisticated RT-CGM systems developed to date and became available in Canada in 2019. A health economic analysis was performed to determine the long-term cost-effectiveness of the Dexcom G6 RT-CGM system versus SMBG in adults with type 1 diabetes (T1D) in Canada.Methods: The analysis was performed using the IQVIA Core Diabetes Model. Based on clinical trial data, patients with mean baseline HbA1c of 8.6% were assumed to have a HbA1c reduction of 1.0% with RT-CGM versus 0.4% reduction with SMBG. RT-CGM was also associated with a quality of life (QoL) benefit owing to reduced incidence of hypoglycemia, reduced fear of hypoglycemia (FoH) and elimination of fingerstick testing. Direct medical costs were sourced from published literature, and inflated to 2019 Canadian dollars (CAD).Results: Dexcom G6 RT-CGM was projected to improve mean quality-adjusted life expectancy by 2.09 quality-adjusted life years (QALYs) relative to SMBG (15.52 versus 13.43 QALYs) but mean total lifetime cots were CAD 35,353 higher with RT-CGM (CAD 227,357 versus CAD 192,004) resulting in an incremental cost-effectiveness ratio (ICER) of CAD 16,931 per QALY gained. Sensitivity analyses revealed that assumptions relating to the QoL benefit associated with reduced FoH and the elimination of fingerstick testing with RT-CGM as well as SMBG usage and change in HbA1c were the key drivers of cost-effectiveness.Conclusion: For adults with T1D in Canada, RT-CGM is associated with improved glycemic control and QoL benefits owing to a reduced FoH and elimination of the requirement for fingerstick testing and over a lifetime time horizon is cost-effective relative to SMBG.Keywords: type 1 diabetes, Canada, real-time continuous glucose monitoring, cost-effectivenesshttps://www.dovepress.com/evaluation-of-the-long-term-cost-effectiveness-of-the-dexcom-g6-contin-peer-reviewed-fulltext-article-CEORtype 1 diabetescanadareal-time continuous glucose monitoringcost-effectiveness |
| spellingShingle | Roze S Isitt JJ Smith-Palmer J Lynch P Evaluation of the Long-Term Cost-Effectiveness of the Dexcom G6 Continuous Glucose Monitor versus Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in Canada ClinicoEconomics and Outcomes Research type 1 diabetes canada real-time continuous glucose monitoring cost-effectiveness |
| title | Evaluation of the Long-Term Cost-Effectiveness of the Dexcom G6 Continuous Glucose Monitor versus Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in Canada |
| title_full | Evaluation of the Long-Term Cost-Effectiveness of the Dexcom G6 Continuous Glucose Monitor versus Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in Canada |
| title_fullStr | Evaluation of the Long-Term Cost-Effectiveness of the Dexcom G6 Continuous Glucose Monitor versus Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in Canada |
| title_full_unstemmed | Evaluation of the Long-Term Cost-Effectiveness of the Dexcom G6 Continuous Glucose Monitor versus Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in Canada |
| title_short | Evaluation of the Long-Term Cost-Effectiveness of the Dexcom G6 Continuous Glucose Monitor versus Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in Canada |
| title_sort | evaluation of the long term cost effectiveness of the dexcom g6 continuous glucose monitor versus self monitoring of blood glucose in people with type 1 diabetes in canada |
| topic | type 1 diabetes canada real-time continuous glucose monitoring cost-effectiveness |
| url | https://www.dovepress.com/evaluation-of-the-long-term-cost-effectiveness-of-the-dexcom-g6-contin-peer-reviewed-fulltext-article-CEOR |
| work_keys_str_mv | AT rozes evaluationofthelongtermcosteffectivenessofthedexcomg6continuousglucosemonitorversusselfmonitoringofbloodglucoseinpeoplewithtype1diabetesincanada AT isittjj evaluationofthelongtermcosteffectivenessofthedexcomg6continuousglucosemonitorversusselfmonitoringofbloodglucoseinpeoplewithtype1diabetesincanada AT smithpalmerj evaluationofthelongtermcosteffectivenessofthedexcomg6continuousglucosemonitorversusselfmonitoringofbloodglucoseinpeoplewithtype1diabetesincanada AT lynchp evaluationofthelongtermcosteffectivenessofthedexcomg6continuousglucosemonitorversusselfmonitoringofbloodglucoseinpeoplewithtype1diabetesincanada |