Cost calculation for a flash glucose monitoring system for UK adults with type 1 diabetes mellitus receiving intensive insulin treatment

Diabetes Res Clin Pract. 2018 Apr:138:193-200. doi: 10.1016/j.diabres.2018.01.028. Epub 2018 Feb 2.

Abstract

Aims: To estimate the costs associated with a flash glucose monitoring system as a replacement for routine self-monitoring of blood glucose (SMBG) in patients with type 1 diabetes mellitus (T1DM) using intensive insulin, from a UK National Health Service (NHS) perspective.

Methods: The base-case cost calculation was created using the maximum frequency of glucose monitoring recommended by the 2015 National Institute for Health and Care Excellence guidelines (4-10 tests per day). Scenario analyses considered SMBG at the frequency observed in the IMPACT clinical trial (5.6 tests per day) and at the frequency of flash monitoring observed in a real-world analysis (16 tests per day). A further scenario included potential costs associated with severe hypoglycaemia.

Results: In the base case, the annual cost per patient using flash monitoring was £234 (19%) lower compared with routine SMBG (10 tests per day). In scenario analyses, the annual cost per patient of flash monitoring compared with 5.6 and 16 SMBG tests per day was £296 higher and £957 lower, respectively. The annual cost of severe hypoglycaemia for flash monitoring users was estimated to be £221 per patient, compared with £428 for routine SMBG users (based on 5.6 tests/day), corresponding to a reduction in costs of £207.

Conclusions: The flash monitoring system has a modest impact on glucose monitoring costs for the UK NHS for patients with T1DM using intensive insulin. For people requiring frequent tests, flash monitoring may be cost saving, especially when taking into account potential reductions in the rate of severe hypoglycaemia.

Keywords: Calculation; Cost; Diabetes; Flash; Hypoglycaemia; Monitoring.

MeSH terms

  • Adult
  • Blood Glucose Self-Monitoring / economics
  • Blood Glucose Self-Monitoring / instrumentation
  • Costs and Cost Analysis
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / economics*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Dose-Response Relationship, Drug
  • Equipment and Supplies / economics*
  • Female
  • Health Care Costs*
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / chemically induced
  • Hypoglycemia / economics
  • Hypoglycemia / epidemiology
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / adverse effects
  • Insulin / administration & dosage*
  • Insulin / adverse effects
  • Male
  • Middle Aged
  • National Health Programs / economics
  • United Kingdom / epidemiology
  • Young Adult

Substances

  • Hypoglycemic Agents
  • Insulin