Long-term cost-effectiveness of Dexcom G6 real-time continuous glucose monitoring system in people with type 1 diabetes in Australia.

Autor: Isitt JJ; Vyoo Agency, San Diego, California, USA., Roze S; Vyoo Agency, Lyon, France., Tilden D; THEMA Consulting, Sydney, Australia., Arora N; THEMA Consulting, Sydney, Australia., Palmer AJ; Menzies Institute for Medical Research, The University of Tasmania, Hobart, Australia., Jones T; Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Western Australia, Australia.; Division of Pediatrics within the Medical School, The University of Western Australia, Perth, Western Australia, Australia.; Children's Diabetes Centre, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia., Rentoul D; Dexcom, San Diego, California, USA., Lynch P; Dexcom, San Diego, California, USA.
Jazyk: angličtina
Zdroj: Diabetic medicine : a journal of the British Diabetic Association [Diabet Med] 2022 Jul; Vol. 39 (7), pp. e14831. Date of Electronic Publication: 2022 Mar 25.
DOI: 10.1111/dme.14831
Abstrakt: Introduction: Real-time continuous glucose monitoring (rt-CGM) allows patients with diabetes to adjust insulin dosing, potentially improving glucose control. This study aimed to compare the long-term cost-effectiveness of the Dexcom G6 rt-CGM device versus self-monitoring of blood glucose (SMBG) and flash glucose monitoring (FGM) in Australia in people with type 1 diabetes (T1D).
Methods: Long-term costs and clinical outcomes were estimated using the CORE Diabetes Model. Clinical input data for the analysis of rt-CGM versus SMBG and FGM were sourced from the DIAMOND study and a network meta-analysis, respectively. Rt-CGM and FGM were associated with quality of life (QoL) benefits due to reduced fear of hypoglycaemia (FoH) and fingerstick testing. Analyses were performed over a lifetime time horizon from an Australian healthcare payer perspective, including direct costs from published data. Future costs and clinical outcomes were discounted at 5% per annum.
Results: Rt-CGM was associated with an increased quality-adjusted life expectancy of 1.199 quality-adjusted life years (QALYs), increased mean total lifetime costs of AUD 21,596 and an incremental cost-effectiveness ratio (ICER) of AUD 18,020 per QALY gained compared with SMBG. Compared with FGM, rt-CGM was associated with an increased quality-adjusted life expectancy of 0.569 QALYs, increased mean total lifetime costs of AUD 11,064 and an ICER of AUD 19,455 per QALY gained. Key drivers of outcomes included HbA 1c benefits and QoL benefits associated with reduced FoH and fingerstick testing.
Conclusions: Due to improved clinical outcomes and QoL gains rt-CGM is highly cost-effective compared with SMBG and FGM in people with T1D in Australia.
(© 2022 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)
Databáze: MEDLINE
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