CGM lowers health care costs, improves adherence vs. SMBG

ORLANDO, Fla. — Among patients with type 1 and type 2 diabetes prescribed multiple daily injection therapy, the use of continuous glucose monitoring was associated with lower health care costs and improved adherence vs. self-monitoring blood glucose, according to findings presented here.

“Many people do not meet the recommended frequency of SMBG owning to various factors, including the inconvenience and invasiveness of the testing procedure, pain and social stigma,” Richard Hellmund, MSc, a global health economist at Abbott Diabetes Care, and colleagues wrote in a poster presented at the American Diabetes Association Scientific Sessions. “In the U.S., people with diabetes being treated with [multiple daily injection] have been estimated to test 2.6 times per day.”

In order to estimate the costs of CGM when used as a replacement for routine SMBG, researchers analyzed data from the IMPACT (type 1 diabetes) and the REPLACE (type 2 diabetes) trials, which looked at CGM vs. SMBG from a clinical standpoint. Results from these trials suggest that CGM users with type 1 and type 2 diabetes conducted a mean of 0.5 and 0.3 SMBG tests per day, respectively. A cost calculation was then created based on SMBG testing frequencies of six and 10 per day, as recommended in the 2017 ADA Standards of Care, according to researchers. The calculation also included the undiscounted price for test strips (mean of leading manufacturers’ U.S. list prices in January 2018, $1.42) and discounted price per strip (mean, 60 cents).

When using undiscounted test strips, researchers found that the cost per person per month of CGM use (with some self-monitoring) is approximately $129 in those with type 1 diabetes and $121 in those with type 2 diabetes vs. $256 (performing six SMBG tests per day) and $426 (performing 10 SMBG tests per day) for routine SMBG users. When using discounted test trips, the cost per person per month of CGM use (with some self-monitoring) is about $117 in people with type 1 diabetes and $113 in those with type 2 diabetes vs. $108 (performing six SMBG tests per day) and $180 (performing 10 SMBG tests per day) for routine SMBG users. The cost of CGM use in both scenarios remains irrespective of scanning frequency, according to researchers.

“Based on U.S. acquisition costs and ADA-recommended testing frequencies, flash monitoring is overall cost-saving compared with SMBG in people with [type 1 diabetes] or [type 2 diabetes] using [multiple daily injection] therapy,” the researchers wrote. “In this population, flash monitoring has been shown to be associated with changes in behavior leading to improved adherence to ADA Standards of Care for glucose monitoring frequency.” – by Melissa J. Webb

Reference:

Hellmund R, et al. Cost calculation and adherence to ADA recommendations based on a flash continuous glucose monitoring system for people with T1DM or T2DM using MDI therapy. Presented at: American Diabetes Association 78th Scientific Sessions; June 22-26, 2018; Orlando, Fla.

Disclosures: The poster was supported by Oxford PharmaGenesis. Hellmund reports he is a full-time employee of Abbott Diabetes Care.