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Cost-effectiveness of continuous glucose monitoring with FreeStyle Libre(®) in Brazilian insulin-treated patients with types 1 and 2 diabetes mellitus

BACKGROUND: Hypoglycemia is a barrier to optimal glucose control in the treatment of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Blood glucose monitoring is essential in diabetes management. Inappropriate glucose management is associated with high mortality and morbidity. FreeStyle Libre...

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Autores principales: Bahia, Luciana, Mello, Karla F., Lemos, Lívia Lovato Pires, Costa, Naiane Lima, Mulinari, Eduardo, Malerbi, Domingos A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10675900/
https://www.ncbi.nlm.nih.gov/pubmed/38001509
http://dx.doi.org/10.1186/s13098-023-01208-5
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author Bahia, Luciana
Mello, Karla F.
Lemos, Lívia Lovato Pires
Costa, Naiane Lima
Mulinari, Eduardo
Malerbi, Domingos A.
author_facet Bahia, Luciana
Mello, Karla F.
Lemos, Lívia Lovato Pires
Costa, Naiane Lima
Mulinari, Eduardo
Malerbi, Domingos A.
author_sort Bahia, Luciana
collection PubMed
description BACKGROUND: Hypoglycemia is a barrier to optimal glucose control in the treatment of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Blood glucose monitoring is essential in diabetes management. Inappropriate glucose management is associated with high mortality and morbidity. FreeStyle Libre(®) (FSL) is a continuous glucose monitoring (CGM) system that provides effective, safe, and convenient glucose monitoring, without routine finger pricking. This study aims to estimate the incremental cost-effectiveness ratio (ICER) of the FSL system in comparison to conventional Self-monitoring of blood glucose (SMBG) in T1DM and T2DM patients that require intensive insulin therapy. METHODS: A decision-tree model was developed to compare the cost-effectiveness ratio between FSL and conventional SMBG from the perspective of the Brazilian Public Healthcare System (SUS). The model captures the cumulative rates of acute complications such as severe hypoglicemia and diabetic ketoacidosis, per-event costs, and quality-adjusted life-years (QALYs) gained over a 1-year time horizon in adult and pediatric patients (≥ 4 years old) with T1DM or T2DM. Inputs from the Brazilian health databases, clinical trials, and real-world data were used in the study. RESULTS: The results demonstrated that, regarding solely severe hypoglicemia and diabetic ketoacidosis events, T1DM have a QALY difference of 0.276, a cost difference of R$ 7.255, and an ICER of R$ 26,267.69 per QALY gained for CGM with FSL, when compared to conventional SMBG. T2DM results demonstrated equally a QALY difference of 0.184, a cost difference of R$ 7290, and an ICER of R$ 39,692.67 per QALY gained, in favour of CGM with FSL. CONCLUSION: Our findings demonstrated that FSL is cost-effective in T1DM and T2DM for acute diabetic complications, from a SUS perspective. CGM with FSL can promote safe, convenient, and cost-effective glucose monitoring, therefore contributing to the improvement of the incidence of complications and quality of life.
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spelling pubmed-106759002023-11-25 Cost-effectiveness of continuous glucose monitoring with FreeStyle Libre(®) in Brazilian insulin-treated patients with types 1 and 2 diabetes mellitus Bahia, Luciana Mello, Karla F. Lemos, Lívia Lovato Pires Costa, Naiane Lima Mulinari, Eduardo Malerbi, Domingos A. Diabetol Metab Syndr Research BACKGROUND: Hypoglycemia is a barrier to optimal glucose control in the treatment of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Blood glucose monitoring is essential in diabetes management. Inappropriate glucose management is associated with high mortality and morbidity. FreeStyle Libre(®) (FSL) is a continuous glucose monitoring (CGM) system that provides effective, safe, and convenient glucose monitoring, without routine finger pricking. This study aims to estimate the incremental cost-effectiveness ratio (ICER) of the FSL system in comparison to conventional Self-monitoring of blood glucose (SMBG) in T1DM and T2DM patients that require intensive insulin therapy. METHODS: A decision-tree model was developed to compare the cost-effectiveness ratio between FSL and conventional SMBG from the perspective of the Brazilian Public Healthcare System (SUS). The model captures the cumulative rates of acute complications such as severe hypoglicemia and diabetic ketoacidosis, per-event costs, and quality-adjusted life-years (QALYs) gained over a 1-year time horizon in adult and pediatric patients (≥ 4 years old) with T1DM or T2DM. Inputs from the Brazilian health databases, clinical trials, and real-world data were used in the study. RESULTS: The results demonstrated that, regarding solely severe hypoglicemia and diabetic ketoacidosis events, T1DM have a QALY difference of 0.276, a cost difference of R$ 7.255, and an ICER of R$ 26,267.69 per QALY gained for CGM with FSL, when compared to conventional SMBG. T2DM results demonstrated equally a QALY difference of 0.184, a cost difference of R$ 7290, and an ICER of R$ 39,692.67 per QALY gained, in favour of CGM with FSL. CONCLUSION: Our findings demonstrated that FSL is cost-effective in T1DM and T2DM for acute diabetic complications, from a SUS perspective. CGM with FSL can promote safe, convenient, and cost-effective glucose monitoring, therefore contributing to the improvement of the incidence of complications and quality of life. BioMed Central 2023-11-25 /pmc/articles/PMC10675900/ /pubmed/38001509 http://dx.doi.org/10.1186/s13098-023-01208-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Bahia, Luciana
Mello, Karla F.
Lemos, Lívia Lovato Pires
Costa, Naiane Lima
Mulinari, Eduardo
Malerbi, Domingos A.
Cost-effectiveness of continuous glucose monitoring with FreeStyle Libre(®) in Brazilian insulin-treated patients with types 1 and 2 diabetes mellitus
title Cost-effectiveness of continuous glucose monitoring with FreeStyle Libre(®) in Brazilian insulin-treated patients with types 1 and 2 diabetes mellitus
title_full Cost-effectiveness of continuous glucose monitoring with FreeStyle Libre(®) in Brazilian insulin-treated patients with types 1 and 2 diabetes mellitus
title_fullStr Cost-effectiveness of continuous glucose monitoring with FreeStyle Libre(®) in Brazilian insulin-treated patients with types 1 and 2 diabetes mellitus
title_full_unstemmed Cost-effectiveness of continuous glucose monitoring with FreeStyle Libre(®) in Brazilian insulin-treated patients with types 1 and 2 diabetes mellitus
title_short Cost-effectiveness of continuous glucose monitoring with FreeStyle Libre(®) in Brazilian insulin-treated patients with types 1 and 2 diabetes mellitus
title_sort cost-effectiveness of continuous glucose monitoring with freestyle libre(®) in brazilian insulin-treated patients with types 1 and 2 diabetes mellitus
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10675900/
https://www.ncbi.nlm.nih.gov/pubmed/38001509
http://dx.doi.org/10.1186/s13098-023-01208-5
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