Background: Type 2 diabetes poses an economic burden to healthcare systems. For individuals with non-intensively treated T2DM, it is unclear whether the use of CGM would add health-economic value. The aim of this study was to compare the costs of SMBG compared to CGM in non-intensively treated T2DM.
Methods: A retrospective cost-analysis using the IBM® MarketScan® Databases was conducted. T2DM patients aged ≥18 years who were using SMBG or initiated CGM between Jan 2018 and March 20were eligible for inclusion. Inclusion criteria included two consecutive claims for T2DM or one claim for T2DM and a claim for glucose lowering therapy, at least one pharmacy claim for SMBG strips or CGM sensors and continuous enrollment for 1-year before and after the index date. Individuals with CGM in pre-index period, pregnancy, rapid-acting insulin, glucagon, T1DM, gestational or secondary diabetes were excluded. SMBG and CGM patients were matched using a propensity score and all cause costs during a one-year follow-up period were compared.
Results: A total of 3,498 patients were included in each matched cohort. For CGM patients, 77% used flash monitoring and 23% a real-time CGM. 35% of SMBG and 37% of CGM users were on basal insulin. Considering median values, SMBG total healthcare costs per person/year were $1,934 less vs. CGM users (p < 0.05) . SMBG patients had significantly lower pharmacy cost (-$2,257, p<0.05) and lower expenses for glucose-lowering treatments (-$1,045, p<0.05) than CGM. Both SMBG and CGM cohorts had similar costs related to inpatient and emergency room admissions.
Conclusion: This analysis shows that SMBG is less costly than CGM in non-intensively treated T2DM patients and is associated with lower pharmacy costs, including glucose-lowering medications. Furthermore, no significant differences in the number of emergency room visits or hospitalizations are seen in SMBG and CGM users.
D. Kerr: Advisory Panel; Abbott Diabetes, Novo Nordisk A/S, Sanofi. Consultant; Evidation Health. Research Support; Novo Nordisk A/S. Stock/Shareholder; Glooko, Inc., Hi.Health. I. Duncan: Consultant; Onduo LLC. F. Giorgino: Advisory Panel; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk. Consultant; Lilly Diabetes, Sanofi. Research Support; Lilly Diabetes, Roche Diabetes Care, Takeda Pharmaceutical Company Limited. E. Repetto: Employee; Roche Diabetes Care. C. Perkins: Employee; Roche Diagnostics USA. R. Maroun: Employee; Amgen Inc., Roche Diagnostics. M. Rivers: Employee; Roche Diabetes Care. A. Wu: None.