Evaluation of the Long-Term Cost-Effectiveness of the Dexcom G6 Continuous Glucose Monitor versus Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in Canada
Open accessAbstract
BACKGROUND: The Dexcom G6 real-time continuous glucose monitoring (RT-CGM) system is one of the most sophisticated RT-CGM systems developed to date and became available in Canada in 2019. A health economic analysis was performed to determine the long-term cost-effectiveness of the Dexcom G6 RT-CGM system versus SMBG in adults with type 1 diabetes (T1D) in Canada. METHODS: The analysis was performed using the IQVIA Core Diabetes Model. Based on clinical trial data, patients with mean baseline HbA1c of 8.6% were assumed to have a HbA1c reduction of 1.0% with RT-CGM versus 0.4% reduction with SMBG. RT-CGM was also associated with a quality of life (QoL) benefit owing to reduced incidence of hypoglycemia, reduced fear of hypoglycemia (FoH) and elimination of fingerstick testing. Direct medical costs were sourced from published literature, and inflated to 2019 Canadian dollars (CAD). RESULTS: Dexcom G6 RT-CGM was projected to improve mean quality-adjusted life expectancy by 2.09 quality-adjusted life years (QALYs) relative to SMBG (15.52 versus 13.43 QALYs) but mean total lifetime cots were CAD 35,353 higher with RT-CGM (CAD 227,357 versus CAD 192,004) resulting in an incremental cost-effectiveness ratio (ICER) of CAD 16,931 per QALY gained. Sensitivity analyses revealed that assumptions relating to the QoL benefit associated with reduced FoH and the elimination of fingerstick testing with RT-CGM as well as SMBG usage and change in HbA1c were the key drivers of cost-effectiveness. CONCLUSION: For adults with T1D in Canada, RT-CGM is associated with improved glycemic control and QoL benefits owing to a reduced FoH and elimination of the requirement for fingerstick testing and over a lifetime time horizon is cost-effective relative to SMBG.
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Insulin pump therapy and CGM reduce HbA1c, hypoglycaemia, diabetes burden and distress, and are associated with higher quality of life compared to usual care.
“Insulin pump therapy and continuous glucose monitor (CGM) reduce Haemoglobin A1c (HbA1c), hypoglycaemia, diabetes burden and distress, and are associated with higher quality of life (QOL) compared to usual care.”
From Social disadvantage and technology use among adults with type 1 diabetes in Quebec: A cross‐sectional study using data from the Canadian <scp>T1D</scp> ( <scp>BETTER</scp> ) Registry (2025) · cites this paper as [2]
The Methods (Simulation Cohort Characteristics and Treatment Effects; page unavailable) report lower HbA1c and hypoglycemia rates with CGM than with usual care using self-monitoring of blood glucose. The Methods (Costs and Health State Utilities; page unavailable) assign CGM a quality-of-life benefit associated with less fear of hypoglycemia and fewer fingerstick tests. The comparison concerns CGM in adults using multiple daily insulin injections, not insulin pump therapy, and does not establish reduced overall diabetes burden or distress. (LLM, conf=0.90)
Experimental — accuracy not yet measuredEconomic analyses generally support the cost-effectiveness of diabetes technologies owing to a reduction in hypoglycaemia and acute and chronic diabetes complications.
“While these technologies are expensive, economic analyses generally support their cost‐effectiveness owing to a reduction in hypoglycaemia and acute and chronic diabetes complications.”
From Social disadvantage and technology use among adults with type 1 diabetes in Quebec: A cross‐sectional study using data from the Canadian <scp>T1D</scp> ( <scp>BETTER</scp> ) Registry (2025) · cites this paper as [2]
The Results (page unavailable) report that Dexcom G6 was cost-effective versus self-monitoring for adults with type 1 diabetes in Canada; lower rates of severe hypoglycemia and long-term complications partly offset its higher device cost. The paper does not establish that diabetes technologies generally are cost-effective, and its Discussion describes an earlier Canadian analysis that reached a much less favorable cost-effectiveness estimate for continuous glucose monitors. (LLM, conf=0.86)
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“Overall, findings from long-term health economic analyses suggest that for adults with long-standing T1D based in Canada, the use of the Dexcom G6 RT-CGM system represents a cost-effective management option compared with SMBG.”
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- Authors
- Roze, S., Isitt, J. J., Smith-Palmer, J., & Lynch, P.
- Affiliations
- Dexcom (United States) (US)
- Venue
- ClinicoEconomics and Outcomes Research
- Publisher
- Informa UK Limited
- Published
- 2021-08
- Volume
- Volume 13
- Pages
- 717-725
- ISSN
- 1178-6981 (ISSN-L)
- PMC
- PMC8366033
- OpenAlex
- W3193000380
- Cited by
- 15
- References
- 37
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 5 · 2023: 2 · 2022: 3
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- ClinicoEconomics and Outcomes Research (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Dexcom
- 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
- Dexcom G6, continuous glucose monitoring, type 1 diabetes, self-monitoring of blood glucose, cost-effectiveness, hypoglycemia, fear of hypoglycemia, quality-adjusted life years, HbA1c, quality of life, lifetime costs
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