Cost-Effectiveness of FreeStyle Libre for Glucose Self-Management Among People with Diabetes Mellitus: A Canadian Private Payer Perspective.

IF 3.8 3区医学 Q2 Medicine

Diabetes Therapy Pub Date : 2025-02-01 Epub Date: 2024-12-17 DOI:10.1007/s13300-024-01677-5

Stewart Harris, Sal Cimino, Yen Nguyen, Kirk Szafranski, Yeesha Poon

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引用次数: 0

Abstract

Introduction: For people living with diabetes, effective glucose monitoring is a key component in diabetes care, helping to reduce disease burden, complications, and healthcare utilization. Sensor-based glucose monitoring systems, which can provide more comprehensive information about glucose levels than capillary-based self-monitoring of blood glucose (SMBG), are becoming established among people living with diabetes. The objective of this study was to assess the cost-effectiveness of glucose monitoring with FreeStyle Libre systems, compared with SMBG, from the perspective of a Canadian private payer.

Methods: The analysis used the validated, person-level microsimulation model DEDUCE (Determination of Diabetes Utilities, Costs, and Effects). Analyses were conducted separately for populations of people with type 1 and type 2 diabetes mellitus (T1DM; T2DM), with time horizons of 40 and 25 years, respectively. T2DM treatment was assumed to be 84% non-insulin, 10% basal insulin, and 6% multiple daily injections of insulin. The effect of FreeStyle Libre was modeled as reductions versus SMBG in glycated hemoglobin level (T1DM, - 0.42%; insulin-treated T2DM, - 0.59%; non-insulin-treated T2DM, - 0.3%) and in acute diabetic events (hypoglycemia and diabetic ketoacidosis). Costs (in 2023 Canadian dollars (Can$)) and utilities were discounted at 1.5%. Outcomes were assessed as costs and quality-adjusted life years (QALYs).

Results: In both populations, FreeStyle Libre was dominant to SMBG, providing more QALYs at a lower cost (T1DM: + 1.25 QALYs, - Can$32,287 costs; T2DM: + 0.48 QALYs, - Can$8091 costs). Reductions were seen in the cumulative incidence of all complications (except blindness in the T1DM analysis). FreeStyle Libre was dominant to SMBG in all scenarios tested. Probabilistic sensitivity analysis showed that FreeStyle Libre had a 100% probability of being dominant to SMBG for T1DM and a 91% probability of being dominant for T2DM.

Conclusion: This economic analysis shows that, from a Canadian private payer perspective, FreeStyle Libre is cost-effective compared with SMBG for all people living with diabetes.

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自由式自由血糖自我管理在糖尿病患者中的成本效益：加拿大私人付款人的观点。

对于糖尿病患者，有效的血糖监测是糖尿病护理的关键组成部分，有助于减少疾病负担、并发症和医疗保健利用。基于传感器的血糖监测系统可以提供比基于毛细血管的血糖自我监测（SMBG）更全面的血糖水平信息，正在糖尿病患者中建立起来。本研究的目的是从加拿大私人支付者的角度，与SMBG相比，评估自由式Libre系统血糖监测的成本效益。方法：分析使用经过验证的个人层面微观模拟模型推导（糖尿病效用、成本和影响的确定）。分别对1型和2型糖尿病(T1DM；2型糖尿病)，时间跨度分别为40年和25年。T2DM治疗假定为84%非胰岛素，10%基础胰岛素，6%每日多次注射胰岛素。自由式自由式的效果建模为糖化血红蛋白水平(T1DM, - 0.42%；胰岛素治疗的T2DM， - 0.59%；非胰岛素治疗的T2DM， - 0.3%)和急性糖尿病事件（低血糖和糖尿病酮症酸中毒）。成本（按2023年加元计算）和公用事业费用折扣率为1.5%。结果评估为成本和质量调整生命年（QALYs）。结果：在这两个人群中，FreeStyle Libre比SMBG占优势，以更低的成本提供更多的QALYs (T1DM: + 1.25 QALYs, - 32,287加元成本；T2DM: + 0.48 QALYs， -成本为8091加元)。所有并发症的累积发生率均有所降低（除了T1DM分析中的失明）。在所有测试场景中，FreeStyle Libre都是SMBG的优势。概率敏感性分析显示，FreeStyle Libre为T1DM的SMBG显性的概率为100%，为T2DM的显性概率为91%。结论：这项经济分析表明，从加拿大私人付款人的角度来看，与SMBG相比，FreeStyle Libre对所有糖尿病患者都具有成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.