Abbott Diabetes Care, Alameda, CA, USA.
Privatklinik Wehrle-Diakonissen Salzburg, Abteilung für Innere Medizin, Haydnstrasse 18, 5020 Salzburg, Austria; Paracelsus Medizinische Privatuniversität, Salzburg, Austria.
Diabetes Res Clin Pract. 2018 Apr;138:193-200. doi: 10.1016/j.diabres.2018.01.028. Epub 2018 Feb 2.
To estimate the costs associated with a flash glucose monitoring system as a replacement for routine self-monitoring of blood glucose (SMBG) in patients with type 1 diabetes mellitus (T1DM) using intensive insulin, from a UK National Health Service (NHS) perspective.
The base-case cost calculation was created using the maximum frequency of glucose monitoring recommended by the 2015 National Institute for Health and Care Excellence guidelines (4-10 tests per day). Scenario analyses considered SMBG at the frequency observed in the IMPACT clinical trial (5.6 tests per day) and at the frequency of flash monitoring observed in a real-world analysis (16 tests per day). A further scenario included potential costs associated with severe hypoglycaemia.
In the base case, the annual cost per patient using flash monitoring was £234 (19%) lower compared with routine SMBG (10 tests per day). In scenario analyses, the annual cost per patient of flash monitoring compared with 5.6 and 16 SMBG tests per day was £296 higher and £957 lower, respectively. The annual cost of severe hypoglycaemia for flash monitoring users was estimated to be £221 per patient, compared with £428 for routine SMBG users (based on 5.6 tests/day), corresponding to a reduction in costs of £207.
The flash monitoring system has a modest impact on glucose monitoring costs for the UK NHS for patients with T1DM using intensive insulin. For people requiring frequent tests, flash monitoring may be cost saving, especially when taking into account potential reductions in the rate of severe hypoglycaemia.
从英国国家医疗服务体系(NHS)的角度出发,评估使用强化胰岛素治疗的 1 型糖尿病(T1DM)患者使用瞬感血糖仪系统替代常规自我血糖监测(SMBG)的相关成本。
基础成本计算是基于 2015 年国家卫生与保健卓越研究所指南(每天 4-10 次检测)建议的最大血糖监测频率创建的。情景分析考虑了 IMPACT 临床试验中观察到的 SMBG 频率(每天 5.6 次检测)和真实世界分析中观察到的瞬感监测频率(每天 16 次检测)。进一步的情景分析包括严重低血糖相关的潜在成本。
在基础案例中,与常规 SMBG(每天 10 次检测)相比,使用瞬感监测的患者每年成本降低了 234 英镑(19%)。在情景分析中,与每天 5.6 次和 16 次 SMBG 检测相比,使用瞬感监测的患者每年成本分别高出 296 英镑和低 957 英镑。估计使用瞬感监测的患者每年严重低血糖的成本为 221 英镑,而使用常规 SMBG 的患者为 428 英镑(基于每天 5.6 次检测),这相当于成本降低了 207 英镑。
对于使用强化胰岛素治疗的 T1DM 患者,瞬感监测系统对英国 NHS 的血糖监测成本仅有适度影响。对于需要频繁检测的患者,瞬感监测可能具有成本效益,尤其是考虑到严重低血糖发生率降低的情况下。