Sierra Joseph A, Shah Mona, Gill Max S, Flores Zachery, Chawla Hiten, Kaufman Francine R, Vigersky Robert
a Medtronic Diabetes, Inc. , Northridge , CA , USA.
J Med Econ. 2018 Mar;21(3):225-230. doi: 10.1080/13696998.2017.1390474. Epub 2017 Oct 17.
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.
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.
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.
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).
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.
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。
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。
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。
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）。
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。
