Modelling potential cost savings from use of real‐time continuous glucose monitoring in pregnant women with Type 1 diabetes
Autor: | Denice S. Feig, A Sale, S De Portu, J. Johanna Sanchez, Helen R. Murphy |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Blood Glucose
medicine.medical_specialty Neonatal intensive care unit endocrine system diseases Total cost Endocrinology Diabetes and Metabolism Pregnancy in Diabetics 030209 endocrinology & metabolism 03 medical and health sciences 0302 clinical medicine Endocrinology Pregnancy Cost Savings Intensive care Diabetes mellitus Intensive Care Units Neonatal Internal Medicine medicine Humans 030212 general & internal medicine health care economics and organizations Research Articles Hyperbilirubinemia Type 1 diabetes business.industry Blood Glucose Self-Monitoring Infant Newborn nutritional and metabolic diseases Length of Stay medicine.disease Hypoglycemia Diabetes Mellitus Type 1 England Research: Pregnancy Emergency medicine Cohort Intensive Care Neonatal Gestation Premature Birth Female business |
Zdroj: | Diabetic Medicine |
ISSN: | 1464-5491 0742-3071 |
Popis: | Aim To investigate potential cost savings associated with the use of real‐time continuous glucose monitoring (RT‐CGM) throughout pregnancy in women with Type 1 diabetes. Methods A budget impact model was developed to estimate, from the perspective of National Health Service England, the total costs of managing pregnancy and delivery in women with Type 1 diabetes using self‐monitoring of blood glucose (SMBG) with and without RT‐CGM. It was assumed that the entire modelled cohort (n = 1441) would use RT‐CGM from 10 to 38 weeks’ gestation (7 months). Data on pregnancy and neonatal complication rates and related costs were derived from published literature, national tariffs, and device manufacturers. Results The cost of glucose monitoring was £588 with SMBG alone and £1820 with RT‐CGM. The total annual costs of managing pregnancy and delivery in women with Type 1 diabetes were £23 725 648 with SMBG alone, and £14 165 187 with SMBG and RT‐CGM; indicating potential cost savings of approximately £9 560 461 from using RT‐CGM. The principal drivers of cost savings were the daily cost of neonatal intensive care unit (NICU) admissions (£3743) and the shorter duration of NICU stay (mean 6.6 vs. 9.1 days respectively). Sensitivity analyses showed that RT‐CGM remained cost saving, albeit to lesser extents, across a range of NICU costs and durations of hospital stay, and with varying numbers of daily SMBG measurements. Conclusions Routine use of RT‐CGM by pregnant women with Type 1 diabetes, would result in substantial cost savings, mainly through reductions in NICU admissions and shorter duration of NICU care. What's new? Real‐time continuous glucose monitoring (RT‐CGM) improves neonatal health outcomes, with fewer large for gestational age infants, fewer neonatal intensive care unit (NICU) admissions and a shorter neonatal length of hospital stay.It is not known whether the costs of implementing RT‐CGM into National Health Service England antenatal care, would be offset by the reduction in neonatal complications.The approximately threefold higher costs of RT‐CGM use, compared with self‐monitoring of blood glucose (£1820 vs. £588), are offset by substantial cost savings, mainly through reductions in NICU admissions and a shorter duration of NICU stay. |
Databáze: | OpenAIRE |
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