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美国2型糖尿病患者使用专业持续葡萄糖监测仪的临床和经济效益:索赔与实验室数据分析

Clinical and economic benefits of professional CGM among people with type 2 diabetes in the United States: analysis of claims and lab data.

作者信息

Sierra Joseph A, Shah Mona, Gill Max S, Flores Zachery, Chawla Hiten, Kaufman Francine R, Vigersky Robert

机构信息

a Medtronic Diabetes, Inc. , Northridge , CA , USA.

出版信息

J Med Econ. 2018 Mar;21(3):225-230. doi: 10.1080/13696998.2017.1390474. Epub 2017 Oct 17.

Abstract

BACKGROUND

It is estimated that one in 10 people in the US have a diagnosis of diabetes. Type 2 diabetes accounts for 95% of all cases in the US, with annual costs estimated to be $246 billion per year. This study investigated the impact of a glucose-measuring intervention to the burden of type 2 diabetes.

OBJECTIVE

This analysis seeks to understand how professional continuous glucose monitoring (professional CGM) impacts clinical and economic outcomes when compared to patients who are not prescribed professional CGM.

METHODS

This study utilized a large healthcare claims and lab dataset from the US, and identified a cohort of patients who were prescribed professional CGM as identified by CPT codes 95250 and 95251. It calculated economic and clinical outcomes 1 year before and 1 year after the use of professional CGM, using a generalized linear model.

RESULTS

Patients who utilized professional CGM saw an improvement in hemoglobin A1C. The "difference-in-difference" calculation for A1C was shown to be -0.44%. There was no statistically significant difference in growth of total annual costs for people who used professional CGM compared to those who did not ($1,270, p = .08). Patients using professional CGM more than once per year had a -$3,376 difference in the growth of total costs (p = .05). Patients who used professional CGM while changing their diabetes treatment regimen also had a difference of -$3,327 in growth of total costs (p = .0023).

CONCLUSION

Significant clinical benefits were observed for patients who used professional CGM. Economic benefits were observed for patients who utilized professional CGM more than once within a 1-year period or who used it during a change of diabetes therapy. This suggests that professional CGM may help decrease rising trends in healthcare costs for people with type 2 diabetes, while also improving clinical outcomes.

摘要

背景

据估计,美国每10人中就有1人被诊断患有糖尿病。2型糖尿病占美国所有病例的95%,每年估计成本为2460亿美元。本研究调查了血糖测量干预对2型糖尿病负担的影响。

目的

本分析旨在了解与未开具专业连续血糖监测(professional CGM)的患者相比,专业连续血糖监测如何影响临床和经济结果。

方法

本研究使用了来自美国的大型医疗保健索赔和实验室数据集,并确定了一组通过CPT代码95250和95251确定开具了专业CGM的患者。使用广义线性模型计算了使用专业CGM前1年和使用后1年的经济和临床结果。

结果

使用专业CGM的患者糖化血红蛋白(A1C)有所改善。A1C的“差值法”计算结果显示为-0.44%。与未使用专业CGM的人相比,使用专业CGM的人年度总成本增长没有统计学上的显著差异(1270美元,p = 0.08)。每年使用专业CGM超过一次的患者总成本增长差异为-3376美元(p = 0.05)。在改变糖尿病治疗方案时使用专业CGM的患者总成本增长也有-3327美元的差异(p = 0.0023)。

结论

使用专业CGM的患者观察到显著的临床益处。在1年内使用专业CGM超过一次或在糖尿病治疗改变期间使用的患者观察到经济效益。这表明专业CGM可能有助于降低2型糖尿病患者医疗成本的上升趋势,同时改善临床结果。

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