Health Economics and Outcomes Research, Dexcom, San Diego, California, USA.
Health Economics and Outcomes Research, Covalence Research Ltd, Harpenden, UK.
Diabetes Obes Metab. 2023 Sep;25(9):2704-2713. doi: 10.1111/dom.15158. Epub 2023 Jun 19.
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.
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。
J Diabetes Sci Technol. 2025-5-7