Introduction & Objective: For people living with diabetes, effective glucose monitoring is recognized as a key component in diabetes care to reduce disease burden, complications, and healthcare utilization. This study aimed to assess the cost-effectiveness of flash CGM, compared with SMBG, from the perspective of a Canadian private payer.
Methods: A recently developed patient-level microsimulation model was used to compare flash CGM with SMBG. Time horizons of 40 years (T1DM) and 25 years (T2DM) were used, reflecting the period of typical private payer coverage. Costs and utilities were discounted at 1.5%. Population characteristics, treatment outcomes, and utilities were based on RCTs and RWE studies. Mean age at model entry was 23 years for T1DM and 40 years for T2DM. T2DM treatment assumptions were: 84% non-insulin; 10% basal insulin; and 6% MDI. Costs were taken from Canadian sources, and included flash CGM and SMBG acquisition costs, the costs to private payers of treating diabetes complications, and absenteeism costs. The primary outcome was cost per quality-adjusted life year (QALY).
Results: For both T1DM and T2DM, flash CGM provided more QALYs than SMBG while reducing costs (Table). Scenario analyses were consistent with the base-case results.
Conclusions: From a Canadian private payer perspective, flash CGM is cost effective compared with SMBG for all people living with diabetes.
S.B. Harris: Consultant; Abbott. Research Support; Boehringer-Ingelheim. Consultant; Dexcom, Inc. Advisory Panel; Eli Lilly and Company. Consultant; Eli Lilly and Company, Novo Nordisk, Sanofi. Research Support; Novartis AG. Consultant; Bayer Inc. S. Cimino: Consultant; Abbott, Boehringer-Ingelheim, Eisai Inc., Eli Lilly and Company, Merck & Co., Inc., Novartis Canada, Novo Nordisk Canada Inc., Takeda Canada. T. Nguyen: None. Y. Poon: Employee; Abbott. K. Szafranski: Consultant; Abbott, Novo Nordisk, Novartis Canada, CSL Behring, AbbVie Inc., Sanofi.
