Cost-Benefit Analysis of Internet Therapeutic Intervention on Patients With Diabetes

Abstract

Background:With the emergence of IBGMS for allowing for patients to communicate their self-monitored blood glucose (SMBG) readings with their health care providers, their impact on the management of diabetes is becoming well-supported with regards to clinical benefits. Their impact on healthcare costs, however, has yet to be investigated. This study aims to determine the cost-benefits of such interventions in comparison to routine care.Objectives:To analyze the cost-benefit of an Internet Blood Glucose Monitoring Service (IBGMS) in comparison to routine diabetes care.Patients and Methods:200 patients were surveyed to assess the cost associated with doctor appointments in the past 12 months. Annual number of visits to medical services for diabetes and costs of transportation, parking, and time taken off work for visits were surveyed. Self-reported frequency of SMBG and most recent A1C were also surveyed. We compared 100 patients who used the IBGMS with 100 patients who only used routine care.Results:There is a trend of lowered total cost in the intervention group compared to the control group. The control group spent $210.89 per year on visits to physicians; the intervention group spent $131.26 (P = 0.128). Patients in control group visited their endocrinologist 1.76 times per year, those in intervention group visited their endocrinologist 1.36 times per year, significantly less frequently than the control group (P = 0.014). Number of visits to other medical services is similar between the groups. Average A1C in intervention group is 7.57%, in control group is 7.69% (P = 0.309).Conclusions:We have demonstrated that IBGMS, while not reaching statistical significance, may be associated with slightly reduced A1C and cost due to visiting physicians.

Blood glucose self-monitoring and internet diabetes management on A1C outcomes in patients with type 2 diabetes

“…Necessary adjustments to each patient's oral medications were communicated, and positive reinforcement was provided if no changes were needed. It is important to note that IBGMS reporting operated in parallel with the conventional standard of diabetes care; although IBGMS patients have been shown to visit their endocrinologists less frequently, 14 they were offered the same short-term and yearly follow-up appointments as non-IBGMS patients.…”

Improved Glycemic Control Through the Use of a Telehomecare Program in Patients with Diabetes Treated with Insulin

“…This is in agreement with a retrospective Canadian study, evaluating cost-effectiveness, which showed a significant reduction in endocrinologist visits for diabetic patients in the telemedicine group compared with the control group. 20 Furthermore, a recent study published by Davidson also reported a pilot project using a remote glucose monitoring utilizing computerized insulin dose adjustment and results showed that the method was safe and effective while saving medical time and face-to-face visit. 21 However, it should be noted that our study reflected a short-term analysis for a 6-month period and that long-term impact on medical visits associated with THC monitoring remains to be explored.…”

Pan-European Economic Analysis to Identify Cost Savings for the Health Care Systems as a Result of Integrating Glucose Monitoring Based Telemedical Approaches Into Diabetes Management

“…56 Furthermore, existing evidence suggest that with telemedical intervention higher costs reduction may occur due to less or shorter regular visits to the endocrinologist. 57 GM with CRI in combination with mobile apps are an optimal solution in digitalized health care systems, where smartphones are expected to be used by 70% to 90% of the world's population by 2020. 58 Differences in cost savings are likely due to heterogeneity in terms of costs of treatment of MI and hypoglycemic episodes.…”