دورية أكاديمية

Estimating the cost‐effectiveness of intermittently scanned continuous glucose monitoring in adults with type 1 diabetes in England

التفاصيل البيبلوغرافية
العنوان: Estimating the cost‐effectiveness of intermittently scanned continuous glucose monitoring in adults with type 1 diabetes in England
المؤلفون: Elliott, Rachel A., Rogers, Gabriel, Evans, Mark L., Neupane, Sankalpa, Rayman, Gerry, Lumley, Sarah, Cranston, Iain, Narendran, Parth, Sutton, Christopher J., Taxiarchi, Vicky P., Burns, Matthew, Thabit, Hood, Wilmot, Emma G., Leelarathna, Lalantha
المساهمون: Diabetes UK
المصدر: Diabetic Medicine ; volume 41, issue 3 ; ISSN 0742-3071 1464-5491
بيانات النشر: Wiley
سنة النشر: 2023
المجموعة: Wiley Online Library (Open Access Articles via Crossref)
الوصف: Objective We previously showed that intermittently scanned continuous glucose monitoring (isCGM) reduces HbA1c at 24 weeks compared with self‐monitoring of blood glucose with finger pricking (SMBG) in adults with type 1 diabetes and high HbA1c levels (58–97 mmol/mol [7.5%–11%]). We aim to assess the economic impact of isCGM compared with SMBG. Methods Participant‐level baseline and follow‐up health status (EQ‐5D‐5L) and within‐trial healthcare resource‐use data were collected. Quality‐adjusted life‐years (QALYs) were derived at 24 weeks, adjusting for baseline EQ‐5D‐5L. Participant‐level costs were generated. Using the IQVIA CORE Diabetes Model, economic analysis was performed from the National Health Service perspective over a lifetime horizon, discounted at 3.5%. Results Within‐trial EQ‐5D‐5L showed non‐significant adjusted incremental QALY gain of 0.006 (95% CI: −0.007 to 0.019) for isCGM compared with SMBG and an adjusted cost increase of £548 (95% CI: 381–714) per participant. The lifetime projected incremental cost (95% CI) of isCGM was £1954 (−5108 to 8904) with an incremental QALY (95% CI) gain of 0.436 (0.195–0.652) resulting in an incremental cost‐per‐QALY of £4477. In all subgroups, isCGM had an incremental cost‐per‐QALY better than £20,000 compared with SMBG; for people with baseline HbA1c >75 mmol/mol (9.0%), it was cost‐saving. Sensitivity analysis suggested that isCGM remains cost‐effective if its effectiveness lasts for at least 7 years. Conclusion While isCGM is associated with increased short‐term costs, compared with SMBG, its benefits in lowering HbA1c will lead to sufficient long‐term health‐gains and cost‐savings to justify costs, so long as the effect lasts into the medium term.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1111/dme.15232
الإتاحة: https://doi.org/10.1111/dme.15232Test
حقوق: http://creativecommons.org/licenses/by-nc/4.0Test/
رقم الانضمام: edsbas.5238A043
قاعدة البيانات: BASE