Introduction: This study was a cost minimization analysis of CGM use versus self-monitoring of blood glucose (SMBG) in T1D pregnancies, inclusive of NICU admission costs.
Methods: Costs of guideline recommended CGM device use and CGM device training, daily glucose finger sticks, and NICU admissions were identified in the literature and inflated to 2023 US dollars. In a base-case scenario, seven daily finger sticks were assumed for both groups in accordance with ADA guidelines for diabetes management in pregnancy. Proportion of births requiring NICU admissions, mean length of NICU stays, and frequency of CGM use were identified in a US retrospective study of the clinical effectiveness of CGM versus SMBG in T1D pregnancies at the Barbara Davis Center for Diabetes (Triple C Study). A scenario analysis assuming costs of real-world CGM device use and real-world frequency of SMBG testing was also conducted.
Results: In the base-case scenario, per-person costs of CGM and SMBG during T1D pregnancy including costs of NICU admissions were US $14,662 and $13,127, respectively. In the scenario analysis, per-person costs of CGM and SMBG were US $12,116 and $12,468, respectively.
Conclusion: The increased cost of CGM use in T1D pregnancies is largely offset by a reduced rate of NICU admissions in a US clinical setting. CGM use in T1D pregnancies is cost-saving when assuming real-world use and frequency of SMBG testing.
M.J. DiStefano: None. R. McQueen: Consultant; Provention Bio, Inc., Genentech, Inc. Advisory Panel; Merck & Co., Inc. V. Gao: None. J.K. Snell-Bergeon: None. M.P. Klein: None. S. Polsky: Other Relationship; diaTribe. Research Support; Dexcom, Inc., Hemsley Charitable Trust, Juvenile Diabetes Research Foundation (JDRF), Medtronic, National Institute of Diabetes and Digestive and Kidney Diseases.
Dexcom, Inc.; NIH/NCRR Colorado CTSI (UL1 RR025780)
