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在芬兰1型糖尿病成年个体的真实环境中,间歇性扫描葡萄糖监测与自我血糖监测的长期健康经济评估

Long-Term Health Economic Evaluation of Intermittently Scanned Glucose Monitoring Compared with Self-Monitoring Blood Glucose in a Real-World Setting in Finnish Adult Individuals with Type 1 Diabetes.

作者信息

Mustonen Jyrki, Rautiainen Päivi, Lamidi Marja-Leena, Lavikainen Piia, Martikainen Janne, Laatikainen Tiina

机构信息

Department of Internal Medicine, Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Joensuu, Finland.

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

出版信息

Diabetes Technol Ther. 2024 Dec;26(12):918-924. doi: 10.1089/dia.2024.0102. Epub 2024 Jul 4.

DOI:10.1089/dia.2024.0102
PMID:38842899
Abstract

There has been an evolving trend in the use of intermittently scanned continuous glucose monitoring (isCGM) among individuals with type 1 diabetes. Although isCGM is proven to be beneficial in the treatment of individuals with type 1 diabetes, its use leads to increasing device costs. This study aimed to investigate the long-term cost-effectiveness of isCGM. Long-term clinical outcomes and costs were projected using the IQVIA Core Diabetes Model (v10.0) based on the observed real-world outcomes of isCGM. The clinical input data for the analysis were sourced from a real-world patient cohort from Eastern Finland, including 877 adult individuals with type 1 diabetes with isCGM (i.e., Freestyle Libre 1 and 2). At the baseline, the patients' mean age was 48 years, and the mean duration of diabetes was 25.8 years. The mean baseline HbA1c was 8.6%, and the mean 12-month change from baseline in HbA1c was -0.37% after the initiation of isCGM. The cost-effectiveness analysis was performed over a lifetime time horizon. A discount rate of 3% was used for the future costs and health outcomes. The projected use of isCGM was associated with improved quality-adjusted life year (QALY) expectancy of 0.84 QALYs after the start of isCGM. The direct lifetime costs were 7861 EUR higher with the use of isCGM, which resulted in an incremental cost-effectiveness ratio of 9396 EUR per QALY gained. According to the present analysis, the use of isCGM is considered cost-effective in adult individuals with type 1 diabetes in a real-world setting in Finland.

摘要

1型糖尿病患者使用间歇性扫描式动态血糖监测(isCGM)的趋势一直在演变。尽管isCGM已被证明对1型糖尿病患者的治疗有益,但其使用会导致设备成本增加。本研究旨在调查isCGM的长期成本效益。基于isCGM观察到的真实世界结果,使用IQVIA核心糖尿病模型(v10.0)预测长期临床结果和成本。分析的临床输入数据来自芬兰东部的一个真实世界患者队列,包括877名使用isCGM(即Freestyle Libre 1和2)的成年1型糖尿病患者。基线时,患者的平均年龄为48岁,糖尿病平均病程为25.8年。平均基线糖化血红蛋白(HbA1c)为8.6%,开始使用isCGM后,HbA1c从基线的平均12个月变化为-0.37%。成本效益分析在终身时间范围内进行。未来成本和健康结果使用3%的贴现率。预测使用isCGM与开始使用isCGM后质量调整生命年(QALY)预期改善0.84个QALY相关。使用isCGM的直接终身成本高出7861欧元,这导致每获得一个QALY的增量成本效益比为9396欧元。根据目前的分析,在芬兰的真实世界环境中,使用isCGM被认为对成年1型糖尿病患者具有成本效益。

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