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Title
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Cost-utility analysis of Dexcom G6 real-time continuous glucose monitoring versus FreeStyle Libre 1 intermittently scanned continuous glucose monitoring in adults with type 1 diabetes in Belgium
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Author
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Abstract
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| Aims/hypothesisThe aim of this study was to assess the long-term cost-effectiveness of Dexcom G6 real-time continuous glucose monitoring (rtCGM) with alert functionality compared with FreeStyle Libre 1 intermittently scanned continuous glucose monitoring (isCGM) without alerts in adults with type 1 diabetes in Belgium.MethodsThe IQVIA CORE Diabetes Model was used to estimate cost-effectiveness. Input data for the simulated baseline cohort were sourced from the randomised ALERTT1 trial (ClinicalTrials.gov. registration no. NCT03772600). The age of the participants was 42.9 +/- 14.1 years (mean +/- SD), and the baseline HbA1c was 57.8 +/- 9.5 mmol/mol (7.4 +/- 0.9%). Participants using rtCGM showed a reduction in HbA1c of 3.6 mmol/mol (0.36 percentage points) based on the 6-month mean between-group difference. In the base case, both rtCGM and isCGM were priced at euro3.92/day (excluding value-added tax [VAT]) according to the Belgian reimbursement system. The analysis was performed from a Belgian healthcare payer perspective over a lifetime time horizon. Health outcomes were expressed as quality-adjusted life years. Probabilistic and one-way sensitivity analyses were used to account for parameter uncertainty.ResultsIn the base case, rtCGM dominated isCGM, resulting in lower diabetes-related complication costs and better health outcomes. The associated main drivers favouring rtCGM were lower HbA1c, fewer severe hypoglycaemic events and reduced fear of hypoglycaemia. The results were robust under a wide range of one-way sensitivity analyses. In models where the price of rtCGM is euro5.11/day (a price increase of 30.4%) or euro12.34/day (a price increase of 214.8%), rtCGM was cost-neutral or reached an incremental cost-effectiveness ratio of euro40,000 per quality-adjusted life year, respectively.Conclusions/interpretationWhen priced similarly, Dexcom G6 rtCGM with alert functionality has both economic and clinical benefits compared with FreeStyle Libre 1 isCGM without alerts in adults with type 1 diabetes in Belgium, and appears to be a cost-effective glucose monitoring modality.Trial registration ClinicalTrials.gov NCT03772600Conclusions/interpretationWhen priced similarly, Dexcom G6 rtCGM with alert functionality has both economic and clinical benefits compared with FreeStyle Libre 1 isCGM without alerts in adults with type 1 diabetes in Belgium, and appears to be a cost-effective glucose monitoring modality.Trial registration ClinicalTrials.gov NCT03772600 |
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Language
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English
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Source (journal)
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Diabetologia / European Association for the Study of Diabetes. - Berlin, 1965, currens
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Publication
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New york
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Springer
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2024
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ISSN
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0012-186X
[print]
1432-0428
[online]
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DOI
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10.1007/S00125-023-06084-2
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Volume/pages
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67
:4
(2024)
, p. 650-662
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ISI
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001144060900002
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Pubmed ID
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38236409
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Full text (Publisher's DOI)
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