Cost analysis of self-monitoring blood glucose in nonintensively managed type 2 diabetes.

OBJECTIVES

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).

STUDY DESIGN

Retrospective analysis of the MarketScan Databases.

METHODS

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.

RESULTS

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.

CONCLUSIONS

In adults with nonintensively managed T2D, SMBG appears to be less costly than CGM and is associated with lower pharmacy costs.