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丹麦接受多次每日胰岛素注射的 1 型糖尿病患者中实时连续血糖监测与自我血糖监测和间歇性扫描连续血糖监测的成本-效用比较。

Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose and intermittently scanned continuous glucose monitoring in people with type 1 diabetes receiving multiple daily insulin injections in Denmark.

机构信息

Health Economics and Outcomes Research, Dexcom, San Diego, California, USA.

Health Economics and Outcomes Research, Covalence Research Ltd, Harpenden, UK.

出版信息

Diabetes Obes Metab. 2023 Sep;25(9):2704-2713. doi: 10.1111/dom.15158. Epub 2023 Jun 19.


DOI:10.1111/dom.15158
PMID:37334522
Abstract

AIMS: To determine the cost-effectiveness of the Dexcom G6 real-time continuous glucose monitoring (rt-CGM) system compared with both the self-monitoring of blood glucose (SMBG) and the Abbott FreeStyle Libre 1 and 2 intermittently scanned CGM (is-CGM) devices in people with type 1 diabetes receiving multiple daily insulin injections in Denmark. MATERIALS AND METHODS: The analysis was performed using the IQVIA Core Diabetes Model, which associates rt-CGM use with glycated haemoglobin reductions of 0.6% and 0.36% based on data from the DIAMOND and ALERTT1 trials, respectively, compared with SMBG and is-CGM use. The analysis was performed from the payer perspective over a 50-year time horizon; future costs and clinical outcomes were discounted at 4% per annum. RESULTS: The use of rt-CGM was associated with an incremental gain of 1.37 quality-adjusted life years (QALYs) versus SMBG. Total mean lifetime costs were Danish Krone (DKK) 894 535 for rt-CGM and DKK 823 474 for SMBG, resulting in an incremental cost-utility ratio of DKK 51 918 per QALY gained versus SMBG. Compared with is-CGM, the use of rt-CGM led to a gain of 0.87 QALYs and higher mean lifetime costs resulting in an incremental cost-utility ratio of DKK 40 879 to DKK 34 367 per QALY gained. CONCLUSIONS: In Denmark, the rt-CGM was projected to be highly cost-effective versus both SMBG and is-CGM, based on a willingness-to-pay threshold of 1× per capita gross domestic product per QALY gained. These findings may help inform future policies to address regional disparities in access to rt-CGM.

摘要

目的:在丹麦,使用多次胰岛素注射治疗 1 型糖尿病的患者中,评估 Dexcom G6 实时连续血糖监测(rt-CGM)系统与自我血糖监测(SMBG)以及 Abbott FreeStyle Libre 1 和 2 间歇性扫描 CGM(is-CGM)设备相比的成本效益。

材料和方法:使用 IQVIA Core Diabetes Model 进行分析,该模型基于 DIAMOND 和 ALERTT1 试验的数据,将 rt-CGM 与 SMBG 和 is-CGM 联合使用,分别关联糖化血红蛋白降低 0.6%和 0.36%。该分析从支付者的角度在 50 年的时间范围内进行;未来的成本和临床结果以每年 4%的贴现率进行贴现。

结果:与 SMBG 相比,使用 rt-CGM 可额外获得 1.37 个质量调整生命年(QALY)。rt-CGM 的终生总成本为丹麦克朗(DKK)894535 丹麦克朗,而 SMBG 的终生总成本为 DKK823474,这导致相对于 SMBG 每获得一个 QALY 的增量成本-效用比为 DKK51918。与 is-CGM 相比,使用 rt-CGM 可额外获得 0.87 个 QALY,且终生总成本更高,导致相对于 SMBG 每获得一个 QALY 的增量成本-效用比为 DKK40879 至 DKK34367。

结论:在丹麦,基于每获得一个 QALY 1×人均国内生产总值的意愿支付阈值,rt-CGM 被预测相对于 SMBG 和 is-CGM 具有高度成本效益。这些发现可能有助于为未来的政策提供信息,以解决实时 CGM 获得方面的区域差异。

相似文献

[1]
Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose and intermittently scanned continuous glucose monitoring in people with type 1 diabetes receiving multiple daily insulin injections in Denmark.

Diabetes Obes Metab. 2023-9

[2]
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J Comp Eff Res. 2024-3

[3]
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J Comp Eff Res. 2023-10

[4]
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Diabet Med. 2022-7

[5]
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[6]
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J Manag Care Spec Pharm. 2024-9

[7]
Long-term Cost-Effectiveness of Dexcom G6 Real-time Continuous Glucose Monitoring Versus Self-Monitoring of Blood Glucose in Patients With Type 1 Diabetes in the U.K.

Diabetes Care. 2020-10

[8]
Cost-utility analysis of a flash continuous glucose monitoring system in the management of people with type 2 diabetes mellitus on basal insulin therapy-An Italian healthcare system perspective.

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[9]
Evaluation of the Long-Term Cost-Effectiveness of the Dexcom G6 Continuous Glucose Monitor versus Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in Canada.

Clinicoecon Outcomes Res. 2021-8-11

[10]
Long-Term Cost-Effectiveness the Dexcom G6 Real-Time Continuous Glucose Monitoring System Compared with Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in France.

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引用本文的文献

[1]
Real-time continuous glucose monitoring vs self-monitoring of blood glucose in distinct multi-ethnic cohorts of patients living with insulin-treated type 2 diabetes in the United States: A cost-utility analysis from a Medicare perspective.

J Manag Care Spec Pharm. 2025-8

[2]
Equity of Continuous Glucose Monitoring in Children and Young People With Type 1 Diabetes: A Systematic Review.

Pediatr Diabetes. 2025-6-3

[3]
A Cross-Sectional Study Demonstrating a High Prevalence of Skin Rash to Diabetes Medical Devices: An Underestimated Problem.

J Diabetes Sci Technol. 2025-5-7

[4]
Expanding the horizon of continuous glucose monitoring into the future of pediatric medicine.

Pediatr Res. 2024-11

[5]
Cost-utility analysis of Dexcom G6 real-time continuous glucose monitoring versus FreeStyle Libre 1 intermittently scanned continuous glucose monitoring in adults with type 1 diabetes in Belgium.

Diabetologia. 2024-4

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