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Evaluation Of The Long-Term Cost-Effectiveness Of Real Time Continuous Glucose Monitoring (Rtcgm) Versus Self Monitoring Of Blood Glucose (Smbg) Alone In Type 1 Diabetes From The Swedish Societal Perspective
Dexcom Inc, Essertines Sur Rolle, Switzerland.
Örebro University, School of Medical Sciences.ORCID iD: 0000-0003-1025-1682
Dexcom Inc, San Diego CA, USA.
Dexcom Inc, San Diego CA, USA.
2017 (English)In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 20, no 9, p. A585-A585Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Objectives: To evaluate the cost-effectiveness of Real-Time CGM (RTCGM (G5)) compared to SMBG alone in Type 1 Diabetes (T1DM) patients using Multiple Daily Injections (MDI) from the Swedish societal perspective.

Methods: The Quintiles IMS CORE Diabetes Model (CDM) (v. 9.0) was used to assess the long-term (50 year) cost-effectiveness of RTCGM compared to SMBG alone for a T1DM cohort. Treatment effects and base-line characteristics of patients were sourced from the recently published DIAMOND trial while all other assumptions and costs were sourced from earlier publications. The accuracy and clinical effectiveness of RTCGM (G5) is equivalent to that seen in CGM (G4SW505) used in the DIAMOND trial. Base case (BC) assumptions included a) starting HbA1c 8.6%; b) change in HbA1c: -1.0% for CGM group, -0.4% for SMBG alone; c) 50% reduction in severe hypoglycemic events (SHEs) and 33% reduction in non-severe hypoglycemic events (NSHEs) for the CGM group; d) dis-utilities of -0.0142 for NSHEs and SHEs not requiring medical interven-tion, and -0.047 for SHEs requiring medical resources. Treatment costs and outcomes were discounted at 3%.

Results: The Incremental Cost-Effectiveness Ratio (ICER) for RTCGM vs. SMBG was SEK 180,530/QALY in the base-case. Sensitivity analyses showed the results were sensitive to changes in percent reduction in severe hypoglycemic events and its associated dis-utilities. An ICER of SEK 188,697/QALY was the result of the sensitivity analysis using the treatment effects from the recent Swedish GOLD study using an earlier version RTCGM. The base-case results were mini-mally impacted by changing starting HbA1c levels and discount rates.

Conclusions: RTCGM has the potential to improve clinical outcomes, quality of life and healthcare efficiencies for the large cohort of MDI-treated patients. The results of this evaluation show that RTCGM (G5) is cost effective within the MDI-treated T1DM population, assuming a willingness-to-pay threshold of SEK 500,000 per Quality-Adjusted Life Year in Sweden.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 20, no 9, p. A585-A585
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-63342ISI: 000413599901396OAI: oai:DiVA.org:oru-63342DiVA, id: diva2:1165480
Available from: 2017-12-13 Created: 2017-12-13 Last updated: 2018-08-13Bibliographically approved

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Jendle, Johan

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