Cost calculation for a flash glucose monitoring system for UK adults with type 1 diabetes mellitus receiving intensive insulin treatment
Cost calculation for a flash glucose monitoring system for UK adults with type 1 diabetes mellitus receiving intensive insulin treatment
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DOI：
10.1016/j.diabres.2018.01.028
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发表时间：
2018-04-01
影响因子：
5.1
通讯作者：
Blissett, Deirdre
中科院分区：
文献类型：
--
作者：
Hellmund, Richard;Weitgasser, Raimund;Blissett, Deirdre
目的：从英国国家医疗服务体系(NHS)的角度，估算使用闪光血糖监测系统替代常规自我血糖监测系统(SMBG)对使用强化胰岛素的1型糖尿病(T1 DM)患者的相关成本。方法：基本成本计算采用2015年国家健康与护理卓越指南推荐的最大血糖监测频率(每天4-10次测试)。情景分析以IMPACT临床试验中观察到的频率(每天5.6次测试)和真实世界分析中观察到的闪光监测频率(每天16次测试)考虑SMBG。结果：在基本情况下，使用闪光监测的每个患者的年成本比常规SMBG(每天10次测试)低234英镑(19%)。在情景分析中，闪光监测与每天5.6次和16次SMBG测试相比，每名患者的年成本分别高出296英镑和低957英镑。闪光监测使用者每年的严重低血糖成本估计为221英镑，而常规SMBG使用者为428英镑(基于5.6次/天的测试)，相应地降低了207磅。结论：对于使用高强度胰岛素的T1 DM患者，闪光监测系统对英国NHS的血糖监测成本影响不大。对于需要频繁检查的人来说，闪光监测可能会节省成本，特别是在考虑到严重低血糖发生率的潜在降低时。(C)2018年作者。爱思唯尔出版公司(Elsevier B.V.)
Aims: To estimate the costs associated with a flash glucose monitoring system as a replacement for routine self-monitoring of blood glucose (SMBG) in patients with type 1 diabetes mellitus (T1DM) using intensive insulin, from a UK National Health Service (NHS) perspective.Methods: The base-case cost calculation was created using the maximum frequency of glucose monitoring recommended by the 2015 National Institute for Health and Care Excellence guidelines (4-10 tests per day). Scenario analyses considered SMBG at the frequency observed in the IMPACT clinical trial (5.6 tests per day) and at the frequency of flash monitoring observed in a real-world analysis (16 tests per day). A further scenario included potential costs associated with severe hypoglycaemia.Results: In the base case, the annual cost per patient using flash monitoring was 234 pound (19%) lower compared with routine SMBG (10 tests per day). In scenario analyses, the annual cost per patient of flash monitoring compared with 5.6 and 16 SMBG tests per day was 296 pound higher and 957 pound lower, respectively. The annual cost of severe hypoglycaemia for flash monitoring users was estimated to be 221 pound per patient, compared with 428 pound for routine SMBG users (based on 5.6 tests/day), corresponding to a reduction in costs of 207 pound.Conclusions: The flash monitoring system has a modest impact on glucose monitoring costs for the UK NHS for patients with T1DM using intensive insulin. For people requiring frequent tests, flash monitoring may be cost saving, especially when taking into account potential reductions in the rate of severe hypoglycaemia. (C) 2018 The Authors. Published by Elsevier B.V.