Continuous Glucose Monitoring Cost-Effective in T1DM

CGM reduces HbA1c, hypoglycemia events for patients with suboptimal control compared to control
CGM reduces HbA1c, hypoglycemia events for patients with suboptimal control compared to control

HealthDay News — For adults with type 1 diabetes (T1D) with suboptimal control despite using multiple insulin injections, continuous glucose monitoring (CGM) seems cost-effective, with improved glucose control, according to a study published online April 12 in Diabetes Care.

Wen Wan, PhD, from the University of Chicago, and colleagues randomized 158 patients with T1D and hemoglobin A1c (HbA1c) ≥7.5% in a 2:1 ratio to CGM versus control. Within-trial and lifetime cost-effectiveness were analyzed. 

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The researchers found that the CGM group had similar quality-adjusted life years (QALYs) to the control group within the 6-month trial (0.462 ± 0.05 versus 0.455 ± 0.06 years; P=0.61). The total 6-month costs were $11,032 and $7,236 for CGM and controls, respectively. Compared with the control group, the CGM group had reductions in HbA1c (0.60 ± 0.74% difference in difference [DiD]; P<0.01), daily rate of non-severe hypoglycemia events (0.07 DiD; P=0.013), and daily strip use (0.55 ± 1.5 DiD; P=0.04). CGM was projected to reduce the risk of T1D complications and increase QALYs by 0.54 in the lifetime analysis. For the overall population, the incremental cost-effectiveness ratio (ICER) was $98,108/QALY. The ICER was reduced to $33,459/QALY by extending sensor use from seven to 10 days in a real-world scenario.

"CGM is cost-effective at the willingness-to-pay threshold of $100,000/QALY, with improved glucose control and reductions in non-severe hypoglycemia," the authors write.

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