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

Abstract

Background: Self-monitoring of blood glucose supported by the diabetes-app OneTouch Reveal® has demonstrated to improve HbA1c. We aimed at analyzing costs savings related the integration of telemedical features into diabetes management. Methods: Data from a randomized controlled trial were used to assess the 10-year risk of patients for fatal myocardial infarction (MI). On the basis of this risk assessments—also related to a 5% or 10% reduction of hypoglycemic episodes—cost savings for the health care systems of five European countries—France, Germany, Italy, Spain, and the United Kingdom—were modeled. Results: HbA1c reduction of 0.92% in insulin-treated type 2 diabetes patients (T2DM) was associated with a 2.3% decreased 10-year risk for fatal MI. In combination with a 10% reduction of hypoglycemic events this risk reduction led to cost savings of €16.1 million (France), €57.8 million (Germany), €30.9 million (Italy), €23.8 million (Spain), and €5.8 million (UK), considering all insulin-treated T2DM patients in the respective countries. Conclusion: Improving metabolic control and thus risk for comorbidities like MI by combining the glucose meter with CRI with telemedical features has the potential to reduce costs for European health care systems.

Costs and Its Drivers for Diabetes Mellitus Type 2 Patients in France and Germany: A Systematic Review of Economic Studies

“…The population varied regarding age and treatment, one study only included employed patients (43). Five studies did not assess the actual costs but used models to estimate costs (35,41,(44)(45)(46). These studies often refer to previous studies for incidence rates and costs.…”

“…Another study estimated direct speci c costs for two different types of insulin: €1671.11 (Exenatide BID twice daily) and €1887.27 (Liraglutide), respectively (55). The other studies report about prescription costs (54) and costs of treatment for hypoglycaemia (35,41). Average annual direct costs for severe hypoglycaemic events (inpatient and outpatient care) of patients with multiple daily insulin injections were €98.91 per patient with annually 0.1 hypoglycaemic events per patient (41).…”

“…Average annual direct costs for severe hypoglycaemic events (inpatient and outpatient care) of patients with multiple daily insulin injections were €98.91 per patient with annually 0.1 hypoglycaemic events per patient (41). Average annual costs for hypoglycaemic episodes per patient are separated in inpatient €2434.74 and outpatient care €531.96, originating from annually 0,19 events per patient (35). Annual costs for antidiabetic prescriptions were €516.28 with a trend of higher costs for men (€537.01), younger patients (≤ 60 years: €568.11), for patients with higher HbA1c (≥ 9: €882.23), for patients with higher BMI (≥ 35: €718.43) and more complications (> 3 complications: €780.64) (54).…”

“…They report average annual diabetes-associated costs of €1642.24 for patients treated with insulin aspart and €2220.76 for patients treated with regular insulin (45). Another study reported diabetes-associated costs for myocardial infarctions of €12448.04 in an acute situation and another €5138.78 in the follow-up (35).…”

“…These innovative solutions are widely considered fundamental for effectively reducing the risk of hypo-and hyperglycaemic events and the risk of follow-up complications (34). Furthermore, continuous monitoring contributes to minimizing medical errors (35).…”