Health State Utilities Associated with Glucose Monitoring Devices

Abstract

The flash glucose monitoring system was associated with a significantly greater utility than the conventional monitoring system. This difference may be useful in cost-utility models comparing the value of glucose monitoring devices for patients with diabetes. This study adds to the literature on treatment process utilities, suggesting that time trade-off methods may be used to quantify preferences among medical devices.

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

“…The intervention-associated utility benefit, derived from a time trade-off study, assumed that flash monitoring offsets the need for SMBG blood tests performed on average three times/day. 42 However, guidelines recommend testing 6–10 times/day, and IMPACT resource utilisation indicates that during the trial, SMBG users tested 5.4 times/day versus 0.5 times/day for flash monitoring users. This greater difference in test frequency may translate into a larger utility benefit.…”

“…Intervention effects for T1D were based on data from IMPACT and captured in Table 2 . 21 , 36 , 41 , 42 No significant differences were seen in the evolution of HbA1c between the two treatment arms in the IMPACT study, so an HbA1c increase of 0.12% (standard deviation [SD] 0.45%); 1.32 mmol/mol [SD 4.95]) compared to baseline was included for both flash monitoring and SMBG. NSHEs were populated using data from the IMPACT trial.…”

“…The base case analysis compared flash monitor use against SMBG use, reflecting the intervention effects summarised in Table 2 . 21 , 36 , 41 , 42 In addition to the base case, scenario analyses (summarised in Table 4 ) explored the impact of key model assumptions. Note that due to the comprehensive nature of the IQVIA CDM, parameters are too numerous to perform systematic univariate sensitivity analyses; however, scenarios tested key inputs, assumptions, and alternate data sources to provide evidence-based clarity on sensitivity to each of these components.…”

Gains in health utility associated with urinary catheter innovations

“…The utility values have face validity, and the levels are comparable to other process-related utilities found in previous studies. 12 , 18 …”

“…The sample size in the present study was larger than similar interview-based vignette studies that have been reported in the past, so that the sensitivity of the study was sufficiently high. 17 , 18 In addition, the trading period in the TTO exercise was not limited to 10 years as is often the case 19 but was extended to each participant’s remaining life expectancy.…”