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从英国视角看,针对使用强化胰岛素治疗的2型糖尿病成人患者的快速血糖监测系统的成本计算

Cost Calculation for a Flash Glucose Monitoring System for Adults with Type 2 Diabetes Mellitus Using Intensive Insulin - a UK Perspective.

作者信息

Hellmund Richard, Weitgasser Raimund, Blissett Deirdre

机构信息

Abbott Diabetes Care, Alameda, CA, US.

Abteilung fur Innere Medizin, Privatklinik Wehrle-Diakonissen, Salzburg, Austria.

出版信息

Eur Endocrinol. 2018 Sep;14(2):86-92. doi: 10.17925/EE.2018.14.2.86. Epub 2018 Sep 10.

Abstract

Estimate the costs associated with flash glucose monitoring as a replacement for routine self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes mellitus (T2DM) using intensive insulin, from a UK National Health Service (NHS) perspective. The base-case cost calculation used the frequency of SMBG and healthcare resource use observed in the REPLACE trial. Scenario analyses considered SMBG at the flash monitoring frequencies observed in the REPLACE trial (8.3 tests per day) and a real-world analysis (16 tests per day). Compared with 3 SMBG tests per day, flash monitoring would cost an additional £585 per patient per year, offset by a £776 reduction in healthcare resource use, based on reductions in emergency room visits (41%), ambulance call-outs (66%) and hospital admissions (77%) observed in the REPLACE trial. Per patient, the estimated total annual cost for flash monitoring was £191 (13.4%) lower than for SMBG. In the scenarios based on acquisition cost alone, flash monitoring was cost-neutral versus 8.3 SMBG tests per day (5% decrease) and cost-saving at higher testing frequencies. From a UK NHS perspective, for patients with T2DM using intensive insulin, flash monitoring is potentially cost-saving compared with routine SMBG irrespective of testing frequency.

摘要

从英国国家医疗服务体系(NHS)的角度,估算在使用强化胰岛素治疗的2型糖尿病(T2DM)患者中,用动态血糖监测替代常规自我血糖监测(SMBG)的相关成本。基础病例成本计算采用了在REPLACE试验中观察到的SMBG频率和医疗资源使用情况。情景分析考虑了在REPLACE试验中观察到的动态血糖监测频率(每天8.3次检测)下的SMBG情况以及一项真实世界分析(每天16次检测)。与每天3次SMBG检测相比,根据REPLACE试验中观察到的急诊就诊次数减少(41%)、救护车出诊次数减少(66%)和住院次数减少(77%),动态血糖监测每位患者每年将额外花费585英镑,但医疗资源使用减少776英镑可抵消这一费用。每位患者而言,动态血糖监测的估计年度总成本比SMBG低191英镑(13.4%)。在仅基于购置成本的情景中,动态血糖监测与每天8.3次SMBG检测相比成本持平(降低5%),且在更高检测频率下可节省成本。从英国NHS的角度来看,对于使用强化胰岛素的T2DM患者,无论检测频率如何,动态血糖监测与常规SMBG相比都可能节省成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6240/6182928/4d0e007e8cd5/euendo-14-86-g001.jpg

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