Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.
Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Diabet Med. 2022 Mar;39(3):e14747. doi: 10.1111/dme.14747. Epub 2021 Nov 27.
To assess the cost-effectiveness of professional-mode flash glucose monitoring in adults with type 2 diabetes in general practice compared with usual clinical care.
An economic evaluation was conducted as a component of the GP-OSMOTIC trial, a pragmatic multicentre 12-month randomised controlled trial enrolling 299 adults with type 2 diabetes in Victoria, Australia. The economic evaluation was conducted from an Australian healthcare sector perspective with a lifetime horizon. Health-related quality of life (EQ-5D) and total healthcare costs were compared between the intervention and the usual care group within the trial period. The 'UKPDS Outcomes Model 2' was used to simulate post-trial lifetime costs, life expectancy and quality-adjusted life years (QALYs).
No significant difference in health-related quality of life and costs was found between the two groups within the trial period. Professional-mode flash glucose monitoring yielded greater QALYs (0.03 [95% CI: 0.02, 0.04]) and a higher cost (A$3807 [95% CI: 3604, 4007]) compared with usual clinical care using a lifetime horizon under the trial-based monitoring frequency, considered not cost-effective (incremental cost-effectiveness ratio = A$120,228). The intervention becomes cost-effective if sensor price is reduced to lower than 50%, or monitoring frequency is decreased to once per year while maintaining the same treatment effect on HbA .
Including professional-mode flash glucose monitoring every 3 months as part of a management plan for people with type 2 diabetes in general practice is not cost-effective, but could be if the sensor price or monitoring frequency can be reduced.
评估在普通诊所中，与常规临床护理相比，专业模式即时血糖监测在 2 型糖尿病成人患者中的成本效益。
作为 GP-OSMOTIC 试验的一部分，进行了一项经济评估，该试验是一项在澳大利亚维多利亚州开展的实用、多中心、12 个月的随机对照试验，纳入了 299 名 2 型糖尿病成人患者。该经济评估从澳大利亚医疗保健部门的角度进行，采用终生时间范围。在试验期间，比较了干预组和常规护理组的健康相关生活质量（EQ-5D）和总医疗保健成本。使用“UKPDS 结果模型 2”来模拟试验后终生的成本、预期寿命和质量调整生命年（QALYs）。
在试验期间，两组之间的健康相关生活质量和成本均无显著差异。采用终生时间范围和基于试验的监测频率，与常规临床护理相比，专业模式即时血糖监测可带来更多的 QALYs（0.03 [95% CI：0.02，0.04]）和更高的成本（A$3807 [95% CI：3604，4007]），被认为不具有成本效益（增量成本效益比为 A$120228）。如果传感器价格降低到低于 50%，或者在保持 HbA1c 治疗效果相同的情况下，将监测频率降低至每年一次，则该干预措施将具有成本效益。
在普通诊所中，将专业模式即时血糖监测每 3 个月作为 2 型糖尿病患者管理计划的一部分，不具有成本效益，但如果传感器价格或监测频率能够降低，则可能具有成本效益。
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