Objectives: In patients with diabetes mellitus (DM) type 2 monitoring of glycated hemoglobin (HbA1c) level is essential to ensure glycemic control. In this study, we assessed overall financial impact of HbA1c monitoring in the point-of-care setting in Belgium, Germany, and Switzerland.

Methods: We developed a health economics model comparing the strategy of using point-of-care (POC) HbA1c monitoring with the strategy of using conventional laboratory-diagnostics (LD) in patients suffering from DM type 2. We followed cohorts of patients diagnosed with DM type 2 in Belgium, Germany and Switzerland for the period of 15 years and estimated the costs of complications (amputation, cataract extraction, kidney failure, heart failure, stroke, and microvascular disease or myocardial infarction) using the local data. To assess the validity of the assumptions and robustness of the model, a thorough sensitivity analysis was undertaken.

Results: In patients with DM type 2, POC HbA1c monitoring resulted in savings of €59.3 million (on average, €182 per patient in the cohort) in Belgium when compared to conventional LD monitoring; corresponding savings in Germany were €848 million (on average, €233 per patient in the cohort) and in Switzerland savings amounted to €118 million (on average, €422 per patient in the cohort). The sensitivity analysis showed robustness of our findings.

Conclusions: Our health economics analysis suggests that the POC HbA1c monitoring in patients suffering from DM type 2 may reduce overall heath care costs in Belgium, Germany, and Switzerland.


A.T. Boltyenkov: Employee; Self; Siemens. F. Navarro: None. R. Hren: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.