Pharmacoeconomics & Outcomes Research Iberia, Pozuelo de Alarcon, Madrid, Spain
Department of Medicine, Universitat de València Facultat de Medicina i Odontologia, Valencia, Comunitat Valenciana, Spain.
BMJ Open Diabetes Res Care. 2020 Jul;8(1). doi: 10.1136/bmjdrc-2020-001330.
Compare cost of the interstitial liquid glucose flash monitoring (FM) system (FreeStyle Libre 2) versus self-monitoring of blood glucose (SMBG) in adults with type 1 diabetes mellitus (T1DM) in Spain.
A model was developed to estimate, with the perspective of the Spanish health system, the annual costs associated with glucose monitoring and hypoglycemic events management in T1DM population, with multiple insulin daily doses (MDI). According to published evidence, rate of severe hypoglycemia (SHE) of 4.90 episodes per patient-year was applied. Reduction of SHE (58.6%) was modeled associated with FM use. Published rates of hospital care (20.2%) and subsequent admission (16%) were assumed for SHE. The daily consumption of strips and lancets was 9 in patients with SMBG (before and after 4 daily intakes and at bedtime) and 0.5 for FM users (according to IMPACT trial findings). Annual consumption of 26 FM sensors was considered (1 every 14 days). Unit costs (in € of 2019, excluding VAT) were obtained from literature and national databases. Sensitivity analyses (SA) were carried out to evaluate the model robustness.
The total annual cost/patient was €4437 for SMBG and €2526 for FM. The use of FM would be associated with an annual savings in the costs of monitoring and managing hypoglycemic events of €1911 per patient-year. In a hypothetical cohort of 1000 patients with T1DM MDI, FM could avoid in 1 year 4900 SHE, 93 hospitalizations for SHE. In addition, the use of FM would generate total savings of up to €1 910 000 per year. In the SA with alternative hypoglycemia events rates and use of strips and lancets, and including non-SHE episodes, savings from €370 000 to €1 760 000 were observed with FM.
The use of the FM system to monitor glucose in adults with T1DM treated with MDI, would reduce hypoglycemic events and would result in cost savings for the health system.
比较西班牙 1 型糖尿病（T1DM）成年患者中间质液葡萄糖闪测系统（FM）（FreeStyle Libre 2）与自我血糖监测（SMBG）的成本。
采用模型，从西班牙卫生系统角度估算 T1DM 人群（每日多次胰岛素注射[MDI]）中与血糖监测和低血糖事件管理相关的年度成本。根据已发表的证据，应用每位患者每年发生 4.90 次严重低血糖（SHE）的发生率。假设 FM 使用可减少 58.6%的 SHE。假设 SHE 患者住院治疗（20.2%）和随后住院（16%）的发生率。SMBG 患者的每日试纸和采血针消耗量为 9（每天 4 次，睡前各 1 次），FM 用户为 0.5（根据 IMPACT 试验结果）。考虑到每年消耗 26 个 FM 传感器（每 14 天 1 个）。单位成本（2019 年不含增值税的€）来自文献和国家数据库。进行敏感性分析（SA）以评估模型的稳健性。
SMBG 患者的总年度患者成本为€4437，FM 患者为€2526。FM 的使用每年可为每位患者节省监测和管理低血糖事件的费用€1911。在 1000 名 MDI 治疗的 T1DM 患者的假设队列中，FM 可在 1 年内避免 4900 次 SHE 和 93 次 SHE 住院治疗。此外，FM 的使用每年可节省高达€191 万。在替代低血糖事件发生率和试纸及采血针使用的 SA 中，FM 可节省 370000 至 1760000 欧元。
在 MDI 治疗的 T1DM 成年患者中使用 FM 系统监测血糖可减少低血糖事件，并为卫生系统节省成本。
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