This clinical cost offset analysis compared rtCGM vs. SMBG in people with type 1 diabetes (T1D) applying results from a 3-year, nonrandomized, prospective, real-world clinical trial (COMISAIR). Clinical effects for HbA1c reduction using rtCGM vs. SMBG combined with MDI (-0.96%) or CSII (-0.71%) after 3 years were converted directly into an economic benefit and inflated ($U.S. 2020). The MDI group showed reduced 3-year event rates for severe hypoglycemia (SH) and diabetic ketoacidosis (DKA) of 68% and 100%, respectively. The CSII group showed 50% and nearly 0% fewer SH and DKA events, respectively, using rtCGM vs. SMBG. Estimated costs for HbA1c reduction (low/high) along with SH and DKA events were taken from published literature and inflated ($U.S. 2020). Switching from SMBG to rtCGM would result in an estimated 487 and 238 fewer SH and DKA events, respectively, for the MDI group and 208 and 8 fewer SH and DKA events in the CSII group. Table 1 describes the potential economic benefit. Sustained reduction in HbA1c for rtCGM vs. SMBG represents over 95% of the potential economic value and per person savings range from $3,555-$6,747 after 3 years. Our modelling study demonstrates compelling clinical and economic benefits of sustained HbA1c control using rtCGM over SMBG in T1D.
J. Soupal: Advisory Panel; Self; Abbott. Consultant; Self; Medtronic, Roche Diabetes Care. Speaker’s Bureau; Self; Dexcom, Inc. J.J. Isitt: Employee; Self; Dexcom, Inc. G. Grunberger: Research Support; Self; Medtronic. M. Prazny: Speaker’s Bureau; Self; Novartis Pharmaceuticals Corporation, Roche Diabetes Care. Other Relationship; Self; Abbott, Boehringer Ingelheim International GmbH, Lilly Diabetes, Medtronic, Novo Nordisk A/S, Sanofi, Teva Pharmaceutical Industries Ltd. C. Parkin: Consultant; Self; Abbott, CeQur Corporation, Dexcom, Inc., DreaMed Diabetes, Novo Nordisk Inc., Onduo, Roche Diabetes Care, Valeritas, Inc. M.E. Minshall: Consultant; Self; Dexcom, Inc. P.M. Lynch: Employee; Self; Dexcom, Inc. Stock/Shareholder; Self; Dexcom, Inc.