Cited by 12Diabetes Management and ResearchHealth Systems, Economic Evaluations, Quality of LifeDiabetes Treatment and Management

Economic value of improved accuracy for self-monitoring of blood glucose devices for type 1 and type 2 diabetes in England

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McQueen, Robert Brett, Breton, Marc D., Craig, Joyce, Holmes, Hayden, Whittington, Melanie D., Ott, Markus A., Campbell, Jonathan D.·2018·Journal of Diabetes Science and Technology

Abstract

Objective: The objective was to model clinical and economic outcomes of self-monitoring blood glucose (SMBG) devices with varying error ranges and strip prices for type 1 and insulin-treated type 2 diabetes patients in England. Methods: We programmed a simulation model that included separate risk and complication estimates by type of diabetes and evidence from in silico modeling validated by the Food and Drug Administration. Changes in SMBG error were associated with changes in hemoglobin A1c (HbA1c) and separately, changes in hypoglycemia. Markov cohort simulation estimated clinical and economic outcomes. A SMBG device with 8.4% error and strip price of £0.30 (exceeding accuracy requirements by International Organization for Standardization [ISO] 15197:2013/EN ISO 15197:2015) was compared to a device with 15% error (accuracy meeting ISO 15197:2013/EN ISO 15197:2015) and price of £0.20. Outcomes were lifetime costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). Results: With SMBG errors associated with changes in HbA1c only, the ICER was £3064 per QALY in type 1 diabetes and £264 668 per QALY in insulin-treated type 2 diabetes for an SMBG device with 8.4% versus 15% error. With SMBG errors associated with hypoglycemic events only, the device exceeding accuracy requirements was cost-saving and more effective in insulin-treated type 1 and type 2 diabetes. Conclusions: Investment in devices with higher strip prices but improved accuracy (less error) appears to be an efficient strategy for insulin-treated diabetes patients at high risk of severe hypoglycemia.

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  1. [8]8. Boettcher C, Wudy SA, Dost A, et al. Self-measured blood glucose values vs. simultaneous laboratory-obtained glucose- concentrations in children and adolescents with type 1 diabe- tes-an analysis of glucose meter accuracy and its impact on metabolic control based on a German/Austrian pediatric diabe- tes registry. Pediatr Diabetes. 2013;14:30.
  2. [33]33. Hayes AJ, Leal J, Gray AM, Holman RR, Clarke PM. UKPDS outcomes model 2: a new version of a model to simulate lifetime health outcomes of patients with type 2 diabetes mellitus using data from the 30 year United Kingdom Prospective Diabetes Study: UKPDS 82. Diabetologia. 2013;56:1925-1933.

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Authors
McQueen, R. B., Breton, M. D., Craig, J., Holmes, H., Whittington, M. D., Ott, M. A., & Campbell, J. D.
Affiliations
  • University of Colorado Anschutz (US)
  • University of Virginia Health System (US)
  • York Health Economics Consortium, York, UK
  • Ascensia Diabetes Care (Switzerland) (CH)
Corresponding author
McQueen, Robert Brett
Venue
Journal of Diabetes Science and Technology
Published
2018-04-21
Volume
12
Issue
5
Pages
992-1001
ISSN
1932-2968 (ISSN-L)
OpenAlex
W2800617467
Cited by
12
References
32
Citations by year
2026: 2 · 2023: 3 · 2021: 1 · 2020: 3 · 2019: 3
FWCI
1.39
Type
journal article
Language
en
Open access
Locations
  • Journal of Diabetes Science and Technology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Ascensia Diabetes Care
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
self-monitoring of blood glucose, blood glucose meter accuracy, type 1 diabetes, type 2 diabetes, insulin-treated diabetes, hypoglycemia, HbA1c, cost-effectiveness, quality-adjusted life years, ISO 15197, diabetes complications
MeSH terms
Blood Glucose, Computer Simulation, Cost-Benefit Analysis, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, England, Glycated Hemoglobin, Humans, Hypoglycemia, Blood Glucose Self-Monitoring

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