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
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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