Are Continuous Glucose Monitors Really Cost Effective for Diabetic Patients?

Are Continuous Glucose Monitors Really Cost Effective for Diabetic Patients?

by Rishika Gupta on Apr 13 2018 5:50 PM
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  • When compared to glucostrips Continuous glucose monitors (CGM) offered significant benefits to people with type 1 diabetes, providing near-real-time measurements of blood sugar levels.
  • Even though CGM was $2,500 more costlier than the daily strips, the overall blood glucose control, and low blood sugar episodes were reduced in people who were using this product.
  • When a lifetime analysis was done, CGM came out to be a good competitor as it reduced the risk of complications from type 1 diabetes and increased the quality of life by six months of good health.
Continuous glucose monitors have been proved to be cost-effective as it also happened to increase the quality of life by six months, finds a new study. The findings of this study are published in the Diabetes Care.
As these continuous glucose monitors are expensive, they have been considered to be noncost-effective.

In order to check the cost-effectiveness of the continuous glucose monitors in adults with type 1 diabetes, the researchers from the University of Chicago conducted a study based on a 6-month clinical trial.

The results were found to be within the thresholds that are normally covered by insurance plans that offer medical services concerned with medical devices. During the six-month trail, the CGMs in total improved overall blood glucose control for the study and reduced low blood sugar episodes.

The study also estimated the cost and the health effect of the CGM machine over the excepted life time of patients. The CGMs were found to increase the quality of life by extending the amount of time that patients enjoy with good health and relatively free of complications.

"If you map out the lifetime of a patient, it’s impressive. The CGM adds years of life and years of quality life," said Elbert Huang, MD, Associate Director of the Chicago Center for Diabetes Translation Research at the University of Chicago and senior author of the study. "While it does cost additional money, the costs saved by a lower risk of complications offset the upfront costs."

The Principle Behind The Continuous Glucose Monitor
  • Continuous glucose monitor monitors blood glucose levels by inserting a tiny sensor the under the skin to test blood sugar levels every few minutes throughout the day.
  • This device then wirelessly sends these data to a monitor.
  • These older CGMs can transmit data to a small stand-alone device like a pager, but the new models can now work with smartphones apps and smart watches.
  • Real time information can be provided to diabetic patients to adjust their physical activity, food intake or insulin levels.
  • This can also in turn lower severe high or low blood sugar episodes.
How was the study conducted?

This trial was based on 158 type 1 diabetes patients who relied on multiple, daily injections of insulin. Two- thirds of this group used CGMs, while the other third used the glucostrips.

At the end of the clinical trial which lasted for six months, the health care cost of CGM was greater at $11,032 when compared to $7,236 of glucose strip testing. The upfront cost of CGM device led to cost differences of about $2,500. But the group with CGM device observed reductions in their hemoglobin A1C levels.

The hemoglobin A1C levels are a common measure to measure blood glucose levels. They also experienced fewer non-severe low blood sugar events.

They used a statistical model to simulate costs and health effects of CGM use over the average expected lifetime of patients. These models calculated quality-adjusted life years (QALYs) for each patient, which means nothing but the amount of time they live free of any complications or serious medical incidents.

And in the lifetime analysis, CGM devise projected to reduce the risk of complications from type 1 diabetes and increase QALYs by .54, basically adding six months of good health.

An incremental cost-effectiveness ratio was calculated, which analyzed the difference in costs for treatment, in this case, the CGM vs. daily test strips, over the health benefit it adds, or the quality of life years.

100,000 dollars per QALY was observed as the cost-effectiveness ratio for the CGM concerning the overall population. This value was found to be very below threshold insurance plans and Medicare. Based on the recommendations ratio was calculated for seven days, but if that use was extended to 10 days, that ratio was reduced to about $33,000 per QALY.

Based on this analysis, the CGM looks like a very valuable technology, one that doesn’t cause harm and makes people’s lives better," Huang said. "Hopefully, this will become an important part of the decision-making process to make the CGM available to more people."

Advances in this new CGM technology will be made at lower costs as it further combines software and everyday digital devices such as smartphones together.

"It hints at a future of chronic disease management that’s more cost-effective and gives patients more control," Huang said. "Basically, all the CGM does is provide information, but that allows patients to change the way they eat or time their medications. It empowers patients to manage their own health."