Schnell Oliver, Erbach Michael, Wintergerst Eva
Forschergruppe Diabetes e.V., Helmholtz Center Munich, Munich-Neuherberg, Germany.
J Diabetes Sci Technol. 2013 Jul 1;7(4):904-12. doi: 10.1177/193229681300700413.
Accuracy standards of blood glucose (BG) meters are currently under review. Revised standards are expected to tighten accuracy requirements. Regarding clinical and financial impact of BG meter accuracy, very little data are available. The aim of this study was to analyze potential cost savings related to higher accuracy of glucose meters in Germany.
As a model for calculation, a reduction of meter error from 20% to 5% was applied. The health economic analysis was based on four main pillars: (1) number of insulin-treated patients; (2) costs for glucose monitoring in Germany; (3) data of a modeling analysis on the impact on hypoglycemic episodes, glycosylated hemoglobin (HbA1c), and, subsequently, myocardial infarctions; and (4) costs of diabetes-related complications in Germany. A reduction of meter error from 20% to 5% was identified to be associated with a 10% reduction in severe hypoglycemic episodes and a 0.39% reduction in HbA1c, which translates into a 0.5% reduction of myocardial infarctions.
According to the health economic analysis, the reduction in severe hypoglycemic episodes and myocardial infarctions led to cost savings of €24.14 per patient per year. Considering 390,000 type 1 diabetes patients or 2.3 million insulin-treated patients in Germany, these savings could be equal to a reduction in health care expenditures of more than €9.4 million and €55.5 million, respectively.
Potential cost savings and clinical effects due to higher accuracy of BG meters should provide an impetus to implementation of tighter accuracy standards and development of glucose meters that provide highest possible accuracy.
血糖仪的准确性标准目前正在审查中。预计修订后的标准将提高准确性要求。关于血糖仪准确性的临床和财务影响,现有数据非常少。本研究的目的是分析德国血糖仪更高准确性所带来的潜在成本节约。
作为计算模型,将血糖仪误差从20%降低到5%。健康经济分析基于四个主要支柱:(1)接受胰岛素治疗的患者数量;(2)德国血糖监测成本;(3)关于对低血糖发作、糖化血红蛋白(HbA1c)以及随后心肌梗死影响的模型分析数据;(4)德国糖尿病相关并发症的成本。血糖仪误差从20%降低到5%与严重低血糖发作减少10%以及HbA1c降低0.39%相关,这转化为心肌梗死减少0.5%。
根据健康经济分析,严重低血糖发作和心肌梗死的减少导致每位患者每年节省成本24.14欧元。考虑到德国39万名1型糖尿病患者或230万名接受胰岛素治疗的患者,这些节省分别相当于医疗保健支出减少超过940万欧元和5550万欧元。
血糖仪更高的准确性所带来的潜在成本节约和临床效果应推动实施更严格的准确性标准以及开发尽可能提供最高准确性的血糖仪。