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快速持续葡萄糖监测系统对接受强化胰岛素治疗的医疗补助糖尿病受益人的预算影响

Budget Impact of the Flash Continuous Glucose Monitoring System in Medicaid Diabetes Beneficiaries Treated with Intensive Insulin Therapy.

作者信息

Frank Jerry R, Blissett Deirdre, Hellmund Richard, Virdi Naunihal

机构信息

COPE Health Solutions, New York, New York, USA.

MedTech Economics, Winchester, United Kingdom.

出版信息

Diabetes Technol Ther. 2021 Sep;23(S3):S36-S44. doi: 10.1089/dia.2021.0263.

Abstract

We assessed the economic impact of using the newest flash continuous glucose monitoring (CGM) among Medicaid beneficiaries with diabetes treated with intensive insulin therapy (IIT). A budget impact analysis was created to assess the impact of increasing the proportion of Medicaid beneficiaries with diabetes on IIT, who use flash CGM by 10%. The analysis included glucose monitoring device costs, cost savings due to reductions in glycated hemoglobin, severe hypoglycemia events, and hyperglycemic emergencies such as diabetic ketoacidosis. The net change in costs per person to adopt flash CGM for three populations treated with IIT (adults with type 1 diabetes [T1D] or type 2 diabetes [T2D], and children and adolescents with T1D or T2D) was calculated; these costs were used to estimate the impact of increasing flash CGM use by 10% to the U.S. Medicaid budget over 1-3 years. The analysis found that flash CGM demonstrated cost savings in all populations on a per patient basis. Increasing use of flash CGM by 10% was associated with a $19.4 million overall decrease in costs over the year and continued to reduce costs by $25.3 million in years 2 and 3. Our results suggest that the new flash CGM system can offer cost savings compared to blood glucose monitoring in Medicaid beneficiaries treated with IIT, especially T1D adults, and children and adolescents. These findings support expanding access to CGM by Medicaid plans.

摘要

我们评估了在接受强化胰岛素治疗(IIT)的医疗补助糖尿病患者中使用最新的实时连续血糖监测(CGM)的经济影响。开展了一项预算影响分析,以评估将接受IIT治疗且使用实时CGM的医疗补助糖尿病患者比例提高10%的影响。该分析包括血糖监测设备成本、因糖化血红蛋白降低、严重低血糖事件以及糖尿病酮症酸中毒等高血糖急症减少而节省的成本。计算了接受IIT治疗的三类人群(1型糖尿病[T1D]或2型糖尿病[T2D]的成人,以及T1D或T2D的儿童和青少年)采用实时CGM的人均成本净变化;这些成本用于估计1至3年内将实时CGM的使用增加10%对美国医疗补助预算的影响。分析发现,实时CGM在所有人群中均显示出每位患者的成本节约。将实时CGM的使用增加10%,在当年总体成本下降1940万美元,在第2年和第3年继续降低成本2530万美元。我们的结果表明,与接受IIT治疗的医疗补助患者(尤其是T1D成人以及儿童和青少年)的血糖监测相比,新的实时CGM系统可节省成本。这些发现支持医疗补助计划扩大CGM的可及性。

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