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Epidemiology/Health Services Research
Cost analysis of the flash monitoring system (FreeStyle Libre 2) in adults with type 1 diabetes mellitus
  1. Itziar Oyagüez1,
  2. Juan Francisco Merino-Torres2,3,
  3. Miguel Brito4,
  4. Virginia Bellido5,
  5. Roque Cardona-Hernandez6,
  6. Fernando Gomez-Peralta7,
  7. Francisco Morales-Perez8
  1. 1Pharmacoeconomics & Outcomes Research Iberia, Pozuelo de Alarcon, Madrid, Spain
  2. 2Department of Medicine, Universitat de València Facultat de Medicina i Odontologia, Valencia, Comunitat Valenciana, Spain
  3. 3Endocrinology and Nutrition, La Fe University and Polytechnic Hospital, Valencia, Spain
  4. 4Endocrinology and Nutrition, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Madrid, Spain
  5. 5Endocrinology and Nutrition, Cruces University Hospital, Barakaldo, País Vasco, Spain
  6. 6Division of Pediatric Endocrinology, Hospital Sant Joan de Deu, Barcelona, Catalunya, Spain
  7. 7Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia, Spain
  8. 8Department of Endocrinology and Nutrition, University Hospital Complex Badajoz, Badajoz, Extremadura, Spain
  1. Correspondence to Itziar Oyagüez; ioyaguez{at}porib.com

Abstract

Introduction Compare cost of the interstitial liquid glucose flash monitoring (FM) system (FreeStyle Libre 2) versus self-monitoring of blood glucose (SMBG) in adults with type 1 diabetes mellitus (T1DM) in Spain.

Research design and methods A model was developed to estimate, with the perspective of the Spanish health system, the annual costs associated with glucose monitoring and hypoglycemic events management in T1DM population, with multiple insulin daily doses (MDI). According to published evidence, rate of severe hypoglycemia (SHE) of 4.90 episodes per patient-year was applied. Reduction of SHE (58.6%) was modeled associated with FM use. Published rates of hospital care (20.2%) and subsequent admission (16%) were assumed for SHE. The daily consumption of strips and lancets was 9 in patients with SMBG (before and after 4 daily intakes and at bedtime) and 0.5 for FM users (according to IMPACT trial findings). Annual consumption of 26 FM sensors was considered (1 every 14 days). Unit costs (in € of 2019, excluding VAT) were obtained from literature and national databases. Sensitivity analyses (SA) were carried out to evaluate the model robustness.

Results The total annual cost/patient was €4437 for SMBG and €2526 for FM. The use of FM would be associated with an annual savings in the costs of monitoring and managing hypoglycemic events of €1911 per patient-year. In a hypothetical cohort of 1000 patients with T1DM MDI, FM could avoid in 1 year 4900 SHE, 93 hospitalizations for SHE. In addition, the use of FM would generate total savings of up to €1 910 000 per year. In the SA with alternative hypoglycemia events rates and use of strips and lancets, and including non-SHE episodes, savings from €370 000 to €1 760 000 were observed with FM.

Conclusions The use of the FM system to monitor glucose in adults with T1DM treated with MDI, would reduce hypoglycemic events and would result in cost savings for the health system.

  • glucose monitoring
  • cost(s)
  • type 1
  • adult diabetes
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2020-001330

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    Footnotes

    • Presented at Presented ay 79th Scientific Sessions. American Diabetes Association (ADA). San Francisco (USA). 2019, 7-11 June

    • Contributors IO developed the model, reviewed the scientific literature, performed the analysis and drafted the manuscript. FG-P, JFM-T, MB, FM-P, VB and RC-H validated the model structure and the inputs and provided information about clinical management of patients with diabetes mellitus in Spain. All the authors contributed to interpretation of the results and reviewed and approved the final version of the manuscript.

    • Funding Abbott Diabetes Care provided unconditioned financial support for performing the analysis.

    • Disclaimer The shape of the circle sensor unit, FreeStyle, Libre, and related brand marks are owned by Abbott.

    • Competing interests Abbott Diabetes Care provided unconditioned financial support for performing the analysis. IO is an employee of PORIB, a consultant specialized in the economic evaluation of healthcare interventions, who provided technical and editorial support for conducting the study. FG-P, JFM-T, MB, FM-P, VB and RC-H received payment from Abbott Diabetes Care for consultant activities related to validation of the parameters and results. None of them received financial compensation for review and co-authorship of this manuscript. All the authors contributed to interpretation of the results and reviewed and approved the final version of the manuscript.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement There are no data in this work.