Diabetes Technology Society, 845 Malcolm Rd, Ste 5, Burlingame, CA 94010. Email:
Am J Manag Care. 2023 Dec;29(12):670-675. doi: 10.37765/ajmc.2023.89422.
To compare health care resource utilization (HCRU) and costs between self-monitoring of blood glucose (SMBG) and continuous glucose monitoring (CGM) users in adults with nonintensively managed type 2 diabetes (T2D).
Retrospective analysis of the MarketScan Databases.
Adults with T2D using SMBG or initiating CGM between January 2018 and March 2019 were eligible for inclusion. Inclusion criteria were (1) 2 consecutive claims for T2D or 1 claim for T2D and a claim for glucose-lowering therapy, (2) at least 1 pharmacy claim for SMBG strips or CGM sensors, and (3) continuous enrollment for 1 year before and after the index date. Individuals with evidence of CGM in the preindex period, pregnancy, use of rapid-acting insulin or glucagon, type 1 diabetes, gestational diabetes, or secondary diabetes at any time during the study period were excluded. SMBG and CGM patients were matched using propensity score, and all-cause HCRU and costs during a 1-year period were compared.
A total of 3498 patients were included in each matched cohort. The per-patient per-year (PPPY) all-cause cost was $20,542 in CGM users vs $19,349 in SMBG users (P < .001). The PPPY cost of glucose-lowering medication was $6312 in CGM users vs $5606 in SMBG users (P < .001). No significant differences in the number of emergency department visits or hospitalizations were observed, but CGM users had more all-cause outpatient visits and office visits with an endocrinologist.
In adults with nonintensively managed T2D, SMBG appears to be less costly than CGM and is associated with lower pharmacy costs.
比较自我血糖监测（SMBG）和连续血糖监测（CGM）使用者在非强化管理的 2 型糖尿病（T2D）成人中的医疗资源利用（HCRU）和成本。
市场扫描数据库的回顾性分析。
符合纳入标准的患者为 2018 年 1 月至 2019 年 3 月期间使用 SMBG 或开始使用 CGM 的 T2D 成人。纳入标准为：（1）连续 2 次或 1 次 T2D 加上 1 次降糖治疗的 T2D 索赔，（2）至少有 1 次 SMBG 试纸或 CGM 传感器的药房索赔，（3）在索引日期前后连续 1 年的参保。在索引前期间有 CGM 证据、妊娠、使用速效胰岛素或胰高血糖素、1 型糖尿病、妊娠期糖尿病或任何时间的继发性糖尿病的个体被排除在外。使用倾向评分对 SMBG 和 CGM 患者进行匹配，比较 1 年内的全因 HCRU 和费用。
在每个匹配队列中，共纳入 3498 例患者。CGM 使用者的每位患者每年（PPPY）全因费用为 20542 美元，而 SMBG 使用者为 19349 美元（P <.001）。CGM 使用者的降糖药物 PPPY 费用为 6312 美元，而 SMBG 使用者为 5606 美元（P <.001）。急诊就诊或住院次数无显著差异，但 CGM 使用者的全因门诊就诊和内分泌科就诊次数更多。
在非强化管理的 T2D 成人中，SMBG 的成本似乎低于 CGM，并且与较低的药房成本相关。
