Beneficios clínicos y económicos de la terapia con bomba de insulina integrada a sistema de monitoreo continuo de glucosa en los pacientes diabéticos tipo 1 en Colombia

Gómez, Ana María; Alfonso-Cristancho, Rafael; Orozco, John Jairo; Lynch, Peter; Prieto, Diana; Saunders, Rhodri; Roze, S; Valencia, J.

doi:10.1016/j.endonu.2016.05.011

Cited by 11 publications

(10 citation statements)

References 29 publications

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“…Integrated systems with a low glucose suspend feature were also reported as not cost-effective, with adjusted ICERs of $249,465 AUD ($175,505 USD) [ 17 ] and $1,114,930 AUD ($784,384 USD) [ 32 ] per QALY gained in the UK and Canada, respectively. The single article that considered CGM alarm features reported it was cost-effective compared to MDI and SMBG, with an adjusted ICER of $43,694 AUD ($30,740 USD) per QALY gained in the Colombian setting [ 43 ]. Herman et al reported on the comparison of modern intensive treatments (MDI with SMBG, CSII with non-integrated CGM, and CSII with SMBG) to ‘basic’ MDI and SMBG therapy limited to one capillary glucose test per day [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…The only economic evaluation that considered integrated systems with CGM alarms compared to MDI with SMBG utilised their own review article (in Spanish) as the source for their clinical assumptions [ 43 ]. Authors reported the largest treatment effect of interventions from any study, citing HbA1c reductions of 1.5% (16.4 mmol/mol) and severe hypoglycaemia rates reducing from 5.22 to 0.37 events per patient/year [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

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Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis

et al. 2020

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Background: With the rapid development of technologies for type 1 diabetes, economic evaluations are integral in guiding cost-effective clinical and policy decisions. We therefore aimed to review and synthesise the current economic literature for available diabetes management technologies and outline key determinants of costeffectiveness. Methods: A systematic search was conducted in April 2019 that focused on modelling or trial based economic evaluations. Searched databases included Medline, Medline in-process and other non-indexed citations, EMBASE, PubMed, All Evidenced Based Medicine Reviews, EconLit, Cost-effectiveness analysis Registry, Research Papers in Economics, Web of Science, PsycInfo, CINAHL, and PROSPERO from inception. We assessed quality of included studies with the Questionnaire to Assess Relevance and Credibility of Modeling Studies for Informing Health Care Decision Making an ISPOR-AMCP-NPC good practice task force report. Screening of abstracts and full-texts, appraisal, and extraction were performed by two independent researches. Results: We identified 16,772 publications, of which 35 were analysed and included 11 health technologies. Despite a lack of consensus, most studies reported that insulin pumps (56%) or interstitial glucose sensors (62%) were costeffective, although incremental cost-effectiveness ratios ranged widely ($14,266-$2,997,832 USD). Cost-effectiveness for combined insulin pumps and glucose sensors was less clear. Determinants of cost-effectiveness included treatment effects on glycosylated haemoglobin and hypoglycaemia, costing of technologies and complications, and measures of utility. Conclusions: Insulin pumps or glucose sensors appeared cost-effective, particularly in populations with higher HbA1c levels and rates of hypoglycaemia. However, cost-effectiveness for combined insulin pumps and glucose sensors was less clear. Registration: The study was registered with PROSPERO, number CRD42017077221.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis

et al. 2020

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“…These devices are known to be costly both for acquisition and maintenance. However, a Spanish study comparing continuous insulin infusion and conventional treatment in people with DM1 found that the use of insulin pump decreased the overall cost of patient care, cost-utility and reduction of complications occurrence in the lifetime 25 . Therefore, users with DM, aware of their rights guaranteed by the Brazilian Constitution, which guarantees access to drugs, materials for insulin application and monitoring of capillary glycemia, provided for in current legislation, have judicial system to obtain insulin pumps by clinical indication.…”

Section: Discussionmentioning

confidence: 99%

Processos judiciais para aquisição de bomba de insulina em Ribeirão Preto

Andrade

Santos

Teixeira³

et al. 2018

Rev. Bioét.

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Resumo Objetivou-se analisar ações judiciais individuais para a aquisição de bomba de insulina movidas por usuários do Sistema Único de Saúde em município do estado de São Paulo, mediante estudo exploratório-descritivo do tipo documental e estatístico, de caráter quantitativo. Foram identificados 40 (6,2%) processos relacionados a demandas por bombas de insulina do total de 636 processos. A maioria das ações foi impetrada por homens para pacientes na faixa etária entre 11 e 20 anos. Foram também identificadas ações para adquirir medicamentos e outros insumos, como glicosímetros, conjuntos de infusão e reservatórios de insulina. O estudo tem como intuito promover discussões sobre direitos e assistência integral da pessoa com diabetes mellitus. Assim, espera-se contribuir para o entendimento de como o processo de judicialização pode auxiliar os usuários a buscar novas perspectivas para o cuidado com a doença.

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“…Thus, glycemic variability in type 1 DM patients using insulin pumps and real-time glucose monitoring devices had an SD reduction from 60.74 to 51.67 mg/dl (p=0.010), and AUC diminished from 41.23 to 21.22 (p<0.001) (35). Moreover, a recent study showed that integrated pump/CGMS technology versus multiple daily injections in T1DM increases life expectancy by 3.51 years (95% CI, 3.47-3.55) (36). A recent study reported benefits of using flash CGMS even in well-controlled T1DM by reduc-ing the time spent in hypoglycemia compared to using SMBG (37).…”

Section: Poc Continuous Glucose Monitoring Systems (Cgms) In Diabetesmentioning

confidence: 99%

Point-of-care testing in diabetes management

Cozma

Vonica

Sitar-Tăut

et al. 2019

Revista Romana De Medicina De Laborator

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The prevalence of diabetes mellitus (DM) has rapidly increased over the last decades, reaching epidemic magnitudes, particularly in lowand middle-income countries. Point-of-care (POC) technology enables decision making near or at the site of patient care. Portable blood glucose meters and HbA1c testing are used by the healthcare provider and millions of patients with diabetes to monitor the safety and effectiveness of the diabetes treatment. However, POC capillary blood glucose and POC HbA1c testing are not recommended for diabetes diagnosis. Rather, they have been used for screening diabetes in lowand middle-income countries to decrease the disease burden.

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Beneficios clínicos y económicos de la terapia con bomba de insulina integrada a sistema de monitoreo continuo de glucosa en los pacientes diabéticos tipo 1 en Colombia

Cited by 11 publications

References 29 publications

Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis

Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis

Processos judiciais para aquisição de bomba de insulina em Ribeirão Preto

Point-of-care testing in diabetes management

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