Cost-effectiveness Analysis of a Flash Glucose Monitoring System for Patients with Type 1 Diabetes Receiving Intensive Insulin Treatment in Sweden

Abstract

Flash glucose monitoring - an alternative to traditional self-monitoring of blood glucose (SMBG) - prevents hypoglycaemic events without impacting glycated haemoglobin (HbA1c).21 Given the potential benefits, this study assessed the cost-effectiveness of using flash monitoring versus SMBG alone in patients with type 1 diabetes (T1D) receiving intensive insulin treatment in Sweden. Methods: This study used the IQVIA CORE Diabetes Model (IQVIA CDM, v9.0) to simulate the impact of flash monitoring versus SMBG over 50 years from the Swedish societal perspective. Trial data informed cohort data, intervention effects, and resource utilisation; literature and Tåndvards-Läkemedelförmånsverket (TLV) sources informed utilities and costs. Scenario analyses explored the effect of key base case assumptions. Results: In base case analysis, direct medical costs for flash monitor use were SEK1,222,333 versus SEK989,051 for SMBG use. Flash monitoring led to 0.80 additional quality-adjusted life years (QALYs; 13.26 versus 12.46 SMBG) for an incremental cost effectiveness ratio (ICER) of SEK291,130/QALY. ICERs for all scenarios remained under SEK400,000/QALY. Conclusion: Hypoglycaemia and health utility benefits due to flash glucose monitoring may translate into economic value compared to SMBG. With robust results across scenario analyses, flash monitoring may be considered cost-effective in a Swedish population of T1D intensive insulin users.

Assessing Diabetes Distress and Sleep Quality in Young Adults with Type 1 Diabetes Using FreeStyle Libre: A Prospective Cohort Study

“…Furthermore, increased awareness of their diabetic condition has been observed in patients using flash glucose monitoring because of the ease of glucose monitoring and a graphic depiction of changes in glucose levels over time [9]. FSL is thought to have greater cost-effectiveness than self-monitoring of blood glucose despite greater direct medical costs [10]. Potential disadvantages of FSL include a lack of alarm system to alert the user to low-or high-glucose concentrations as well as a lack of accuracy at low glucose levels, similar to other continuous glucose monitoring systems [11].…”

Effect of Flash Glucose Monitoring on Glycemic Control, Hypoglycemia, Diabetes-Related Distress, and Resource Utilization in the Association of British Clinical Diabetologists (ABCD) Nationwide Audit

“…In contrast to CGM devices, the FSL does not have alarms to alert the user to hypo/hyperglycemia. However, the advantages of FSL include lower costs and factory calibration, removing the need for frequent painful fingerstick calibrations during the 14-day wear period (5). FSL is also known as intermittent CGM, as data from the FSL sensor are only transmitted when the sensor is scanned with a reading device (reader or mobile phone app).…”

Cost analysis of the flash monitoring system (FreeStyle Libre 2) in adults with type 1 diabetes mellitus

“…The FM system has been positively evaluated in application to patients with T1DM and T2DM by health assessment agencies in a number of countries and regions (France, Norway, Scotland, Sweden, UK, Wales, etc), and published cost-effectiveness analysis have shown the efficiency of the FM system in several settings. 38–43 …”

“…The FM system has been positively evaluated in application to patients with T1DM and T2DM by health assessment agencies in a number of countries and regions (France, Norway, Scotland, Sweden, UK, Wales, etc), and published cost-effectiveness analysis have shown the efficiency of the FM system in several settings. [38][39][40][41][42][43] The use of the FM system as a substitute for test strips in SMBG may result in savings for the National Health system, while also improving disease control and patient quality of life. It would be particularly interesting to conduct future studies and/or registries on the use of this technology in real life, with a view to obtaining information on the clinical, economic and quality of life repercussions for patients in our setting, particularly considering that the digital ecosystem accompanying the FreeStyle Libre 2 system (LibreView, FreeStyle Libre Link, FreeStyle Libre LinkUp) can also have an impact on the patients, their relatives and the healthcare professionals.…”