BALTIMORE — Real-time continuous glucose monitoring (RT-CGM) is cost-effective in diabetes patients, according to a military study.
In making that determination, a study team led by Walter Reed National Military Medical Center researchers used evidence from a randomized, controlled trial that demonstrated RT-CGM reduced A1C for up to nine months among patients with type 2 diabetes not on prandial insulin.
The study, published recently in the Journal of Diabetes Science and Technology, noted that RT-CGM was offered short-term and intermittently as a self-care tool to affect patients’ behavior.1
Study authors pointed out that the analyses projected lifetime clinical and economic outcomes for RT-CGM vs. self-monitoring of blood glucose by finger-stick only. The base-case analysis was consistent with the randomized control trial — RT-CGM for two weeks on/one week off over three months.
A scenario analysis was used to simulate outcomes of an RT-CGM “refresher” after the active intervention of the trial. Using the IMS CORE Diabetes Model, the analysis was conducted from a U.S. third-party payer perspective, including direct costs obtained from published sources and inflated to 2011 dollars. Costs and health outcomes were discounted at 3% per annum.
Results indicate that life expectancy (LE) and quality-adjusted life expectancy (QALE) from RT-CGM were 0.10 and 0.07, with a cost of $653/patient over a lifetime. In addition, incremental LE and QALE from a “refresher” were 0.14 and 0.10, with a cost of $1,312/patient over a lifetime, while incremental cost-effectiveness ratios were $9,319 and $13,030 per LY and QALY gained.
“RT-CGM, as a self-care tool, is a cost-effective disease management option in the United States for people with type 2 diabetes not on prandial insulin,” study authors concluded. “Repeated use of RT-CGM may result in additional cost-effectiveness.”
1 Fonda SJ, Graham C, Munakata J, Powers JM, Price D, Vigersky RA. The Cost-Effectiveness of Real-Time Continuous Glucose Monitoring (RT-CGM) in Type 2 Diabetes. J Diabetes Sci Technol. 2016 Feb 3. pii: 1932296816628547. [Epub ahead of print] PubMed PMID: 26843480.