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Fritzen K, Basinska K, Stautner C, Braun KF, Rubio-Almanza M, Nicolucci A, Kennon B, Vergès B, Hosny Y, Schnell O. Budget Impact of Improved Diabetes Management by Utilization of Glucose Meters With a Color-Range Indicator-Comparison of Five European Healthcare Systems. J Diabetes Sci Technol 2020; 14:262-270. [PMID: 31387385 PMCID: PMC7196878 DOI: 10.1177/1932296819864665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIM Costs for the treatment of diabetes and its comorbidities are a major international issue. A recent randomized clinical trial showed that the introduction of color range indicator (CRI)-based glucose meters (GMs) positively affects the HbA1c of patients with type 1 and type 2 diabetes, when compared to GMs without a CRI. This budget impact analysis aimed to translate this beneficial effect of CRI-based GMs, OneTouch Verio Flex and OneTouch Verio, into potential monetary impact for the healthcare systems of five European countries, Germany, Spain, Italy, France, and the United Kingdom. MATERIAL AND METHODS Data from a randomized controlled trial, evaluating the effect of CRI-based GMs, were used to estimate the ten-year risk of patients for fatal myocardial infarction (MI) as calculated by the UK Prospective Diabetes Study (UKPDS) risk engine. On the basis of assessed risks for MI, the potential monetary impact for the healthcare systems in five European countries was modeled. RESULTS Based on a mean HbA1c reduction of 0.36%, as demonstrated in a randomized controlled trial, the UKPDS risk engine estimated a reduction of 2.4% of the ten-year risk of patients for fatal MI. When applied to our economic model, substantial potential cost savings for the healthcare systems of five European countries were calculated: €547 472 (France), €9.0 million (Germany), €6.0 million (Italy), €841 799 (Spain), and €421 069 (United Kingdom) per year. CONCLUSION Improving metabolic control in patients with diabetes by the utilization of CRI-based GMs may have substantial positive effects on the expenditure of the healthcare systems of several European countries.
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Affiliation(s)
| | - Kornelia Basinska
- Sciarc GmbH, Baierbrunn, Germany
- Institute of Nursing Science, Faculty of
Medicine, University of Basel, Switzerland
| | | | - Karl F. Braun
- Klinik und Poliklinik für
Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München,
Germany
| | - Matilde Rubio-Almanza
- Endocrinology and Nutrition Department
Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Instituto de Investigación Sanitaria La
Fe, Valencia, Spain
| | - Antonio Nicolucci
- Center for Outcomes Research and
Clinical Epidemiology (CORESEARCH), Pescara, Italy
| | - Brian Kennon
- FRCP, Diabetes Centre, Queen Elizabeth
University Hospital, Glasgow, UK
| | - Bruno Vergès
- Endocrinologie, Diabétologie, Maladies
Métaboliques et Nutrition, Centre Hospitalier Universitaire Dijon Bourgogne,
France
| | | | - Oliver Schnell
- Sciarc GmbH, Baierbrunn, Germany
- Forschergruppe Diabetes e.V.,
Muenchen-Neuherberg, Germany
- Oliver Schnell, MD, Forschergruppe Diabetes
e.V., Helmholtz Zentrum Muenchen, Ingolstaedter Landstraße 1,
Muenchen-Neuherberg 85764, Germany.
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Fritzen K, Basinska K, Rubio-Almanza M, Nicolucci A, Kennon B, Vergès B, Zakrzewska K, Schnell O. Pan-European Economic Analysis to Identify Cost Savings for the Health Care Systems as a Result of Integrating Glucose Monitoring Based Telemedical Approaches Into Diabetes Management. J Diabetes Sci Technol 2019; 13:1112-1122. [PMID: 30917691 PMCID: PMC6835181 DOI: 10.1177/1932296819835172] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Self-monitoring of blood glucose supported by the diabetes-app OneTouch Reveal® has demonstrated to improve HbA1c. We aimed at analyzing costs savings related the integration of telemedical features into diabetes management. METHODS Data from a randomized controlled trial were used to assess the 10-year risk of patients for fatal myocardial infarction (MI). On the basis of this risk assessments-also related to a 5% or 10% reduction of hypoglycemic episodes-cost savings for the health care systems of five European countries-France, Germany, Italy, Spain, and the United Kingdom-were modeled. RESULTS HbA1c reduction of 0.92% in insulin-treated type 2 diabetes patients (T2DM) was associated with a 2.3% decreased 10-year risk for fatal MI. In combination with a 10% reduction of hypoglycemic events this risk reduction led to cost savings of €16.1 million (France), €57.8 million (Germany), €30.9 million (Italy), €23.8 million (Spain), and €5.8 million (UK), considering all insulin-treated T2DM patients in the respective countries. CONCLUSION Improving metabolic control and thus risk for comorbidities like MI by combining the glucose meter with CRI with telemedical features has the potential to reduce costs for European health care systems.
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Affiliation(s)
| | - Kornelia Basinska
- Sciarc GmbH, Baierbrunn, Germany
- Institute of Nursing Science, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Matilde Rubio-Almanza
- Endocrinology and Nutrition Department Hospital Universitario y Politécnico La Fe and Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Antonio Nicolucci
- Center for Outcomes Research and Clinical Epidemiology (CORESEARCH), Pescara, Italy
| | - Brian Kennon
- FRCP, Diabetes Centre, Queen Elizabeth University Hospital, Glasgow, UK
| | - Bruno Vergès
- Endocrinologie, Diabétologie, Maladies Métaboliques et Nutrition, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | | | - Oliver Schnell
- Sciarc GmbH, Baierbrunn, Germany
- Forschergruppe Diabetes e.V., Muenchen-Neuherberg, Germany
- Oliver Schnell, MD, Forschergruppe Diabetes e.V., Helmholtz Center Muenchen, Ingolstädter Landstraße 1, 85764 Muenchen-Neuherberg, Germany
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Smith AF, Shinkins B, Hall PS, Hulme CT, Messenger MP. Toward a Framework for Outcome-Based Analytical Performance Specifications: A Methodology Review of Indirect Methods for Evaluating the Impact of Measurement Uncertainty on Clinical Outcomes. Clin Chem 2019; 65:1363-1374. [PMID: 31444309 PMCID: PMC7055686 DOI: 10.1373/clinchem.2018.300954] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 06/20/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND For medical tests that have a central role in clinical decision-making, current guidelines advocate outcome-based analytical performance specifications. Given that empirical (clinical trial-style) analyses are often impractical or unfeasible in this context, the ability to set such specifications is expected to rely on indirect studies to calculate the impact of test measurement uncertainty on downstream clinical, operational, and economic outcomes. Currently, however, a lack of awareness and guidance concerning available alternative indirect methods is limiting the production of outcome-based specifications. Therefore, our aim was to review available indirect methods and present an analytical framework to inform future outcome-based performance goals. CONTENT A methodology review consisting of database searches and extensive citation tracking was conducted to identify studies using indirect methods to incorporate or evaluate the impact of test measurement uncertainty on downstream outcomes (including clinical accuracy, clinical utility, and/or costs). Eighty-two studies were identified, most of which evaluated the impact of imprecision and/or bias on clinical accuracy. A common analytical framework underpinning the various methods was identified, consisting of 3 key steps: (a) calculation of "true" test values; (b) calculation of measured test values (incorporating uncertainty); and (c) calculation of the impact of discrepancies between (a) and (b) on specified outcomes. A summary of the methods adopted is provided, and key considerations are discussed. CONCLUSIONS Various approaches are available for conducting indirect assessments to inform outcome-based performance specifications. This study provides an overview of methods and key considerations to inform future studies and research in this area.
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Affiliation(s)
- Alison F Smith
- Test Evaluation Group, Academic Unit of Health Economics, University of Leeds, Leeds, UK;
- NIHR Leeds In Vitro Diagnostic (IVD) Co-operative, Leeds, UK
| | - Bethany Shinkins
- Test Evaluation Group, Academic Unit of Health Economics, University of Leeds, Leeds, UK
- NIHR Leeds In Vitro Diagnostic (IVD) Co-operative, Leeds, UK
- CanTest Collaborative, UK
| | - Peter S Hall
- Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Claire T Hulme
- Test Evaluation Group, Academic Unit of Health Economics, University of Leeds, Leeds, UK
- Health Economics Group, University of Exeter, Exeter, UK
| | - Mike P Messenger
- NIHR Leeds In Vitro Diagnostic (IVD) Co-operative, Leeds, UK
- CanTest Collaborative, UK
- Leeds Centre for Personalised Medicine and Health, University of Leeds, Leeds, UK
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Das A, Cui X, Chivukula V, Iyer SS. Detection of Enzymes, Viruses, and Bacteria Using Glucose Meters. Anal Chem 2018; 90:11589-11598. [DOI: 10.1021/acs.analchem.8b02960] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Amrita Das
- Department of Chemistry, Center for Diagnostics and Therapeutics, Georgia State University, 788 Petit Science Center, Atlanta, Georgia 30302, United States
| | - Xikai Cui
- Department of Chemistry, Center for Diagnostics and Therapeutics, Georgia State University, 788 Petit Science Center, Atlanta, Georgia 30302, United States
| | - Vasanta Chivukula
- Atlanta Metropolitan State College, 1630 Metropolitan Parkway, Atlanta, Georgia 30310, United States
| | - Suri S. Iyer
- Department of Chemistry, Center for Diagnostics and Therapeutics, Georgia State University, 788 Petit Science Center, Atlanta, Georgia 30302, United States
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Fritzen K, Gutschek B, Coucke B, Zakrzewska K, Hummel M, Schnell O. Improvement of Metabolic Control and Diabetes Management in Insulin-Treated Patients Results in Substantial Cost Savings for the German Health System. J Diabetes Sci Technol 2018; 12:1002-1006. [PMID: 29436251 PMCID: PMC6134610 DOI: 10.1177/1932296818758104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Self-monitoring of blood glucose (SMBG) using the ColourSure™ Technology to visualize target range showed improvement of metabolic control and overall diabetes self-management in insulin-treated patients. This economic analysis aimed to identify cost savings for the German health system resulting from an HbA1c reduction due to the utilization of user-friendly glucose meters. METHODS Patient data from a recently published observational study on SMBG were used for risk evaluations using the UKPDS risk engine. These values were integrated in an economic analysis regarding costs of myocardial infarctions (MIs) related to diabetes for the German health system. Based on an earlier assessment these calculations were combined with a 10% reduction of severe hypoglycemic episodes. In the current study, 0% severe hypoglycemic episodes were observed. RESULTS An HbA1c reduction of 0.69% over 6 months was associated with a 3% decreased risk of MI in 10 years. In this model the decrease led to cost savings of €4.90 per patient-year. Considering 2.3 million insulin-treated patients in Germany, this 3% reduction of MI could result in annual savings of €11.27 million. Combining this with a 10% reduction in severe hypoglycemic events, the cost savings would increase to €30.61 per patient-year or €70.4 million for 2.3 million insulin-treated patients in Germany. CONCLUSION The improvement of metabolic control and diabetes self-management that was achieved with the ColourSure™ Technology has the potential to generate substantial cost savings for the German health system underlining the importance of user-friendly methods for SMBG.
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Affiliation(s)
| | | | | | | | - Michael Hummel
- Forschergruppe Diabetes e.V., Helmholtz Centre Munich, Munich-Neuherberg, Germany
| | - Oliver Schnell
- Sciarc Institute, Baierbrunn, Germany
- Forschergruppe Diabetes e.V., Helmholtz Centre Munich, Munich-Neuherberg, Germany
- Oliver Schnell, MD, Forschergruppe Diabetes e.V., Helmholtz Centre Munich, Ingolstaedter Landstraße 1, 85764 Munich-Neuherberg, Germany.
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McQueen RB, Breton MD, Craig J, Holmes H, Whittington MD, Ott MA, Campbell JD. Economic Value of Improved Accuracy for Self-Monitoring of Blood Glucose Devices for Type 1 and Type 2 Diabetes in England. J Diabetes Sci Technol 2018; 12:992-1001. [PMID: 29681171 PMCID: PMC6134622 DOI: 10.1177/1932296818769098] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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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Affiliation(s)
- Robert Brett McQueen
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Robert Brett McQueen, PhD, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Mail Stop C238, 12850 E Montview Blvd, Aurora, CO 80045, USA.
| | - Marc D. Breton
- Center for Diabetes Technology, University of Virginia Health System, Charlottesville, VA, USA
| | | | | | - Melanie D. Whittington
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Jonathan D. Campbell
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Pleus S, Baumstark A, Rittmeyer D, Jendrike N, Haug C, Freckmann G. Performance of two updated blood glucose monitoring systems: an evaluation following ISO 15197:2013. Curr Med Res Opin 2016; 32:847-55. [PMID: 26809001 DOI: 10.1185/03007995.2016.1146666] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective For patients with diabetes, regular self-monitoring of blood glucose (SMBG) is essential to ensure adequate glycemic control. Therefore, accurate and reliable blood glucose measurements with SMBG systems are necessary. The international standard ISO 15197 describes requirements for SMBG systems, such as limits within which 95% of glucose results have to fall to reach acceptable system accuracy. The 2013 version of this standard sets higher demands, especially regarding system accuracy, than the currently still valid edition. ISO 15197 can be applied by manufacturers to receive a CE mark for their system. Research design and methods This study was an accuracy evaluation following ISO 15197:2013 section 6.3 of two recently updated SMBG systems (Contour * and Contour TS; Bayer Consumer Care AG, Basel, Switzerland) with an improved algorithm to investigate whether the systems fulfill the requirements of the new standard. For this purpose, capillary blood samples of approximately 100 participants were measured with three test strip lots of both systems and deviations from glucose values obtained with a hexokinase-based comparison method (Cobas Integra † 400 plus; Roche Instrument Center, Rotkreuz, Switzerland) were determined. Percentages of values within the acceptance criteria of ISO 15197:2013 were calculated. This study was registered at clinicaltrials.gov (NCT02358408). Main outcome Both updated systems fulfilled the system accuracy requirements of ISO 15197:2013 as 98.5% to 100% of the results were within the stipulated limits. Furthermore, all results were within the clinically non-critical zones A and B of the consensus error grid for type 1 diabetes. Conclusions The technical improvement of the systems ensured compliance with ISO 15197 in the hands of healthcare professionals even in its more stringent 2013 version. Alternative presentation of system accuracy results in radar plots provides additional information with certain advantages. In addition, the surveillance error grid offers a modern tool to assess a system's clinical performance.
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Affiliation(s)
- Stefan Pleus
- a Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm , Ulm , Germany
| | - Annette Baumstark
- a Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm , Ulm , Germany
| | - Delia Rittmeyer
- a Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm , Ulm , Germany
| | - Nina Jendrike
- a Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm , Ulm , Germany
| | - Cornelia Haug
- a Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm , Ulm , Germany
| | - Guido Freckmann
- a Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm , Ulm , Germany
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Bailey TS, Grunberger G, Bode BW, Handelsman Y, Hirsch IB, Jovanovič L, Roberts VL, Rodbard D, Tamborlane WV, Walsh J. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY 2016 OUTPATIENT GLUCOSE MONITORING CONSENSUS STATEMENT. Endocr Pract 2016; 22:231-61. [PMID: 26848630 DOI: 10.4158/ep151124.cs] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there were no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.
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McQueen RB, Breton MD, Ott M, Koa H, Beamer B, Campbell JD. Economic Value of Improved Accuracy for Self-Monitoring of Blood Glucose Devices for Type 1 Diabetes in Canada. J Diabetes Sci Technol 2015; 10:366-77. [PMID: 26275642 PMCID: PMC4773951 DOI: 10.1177/1932296815599551] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The objective was to simulate and compare clinical and economic outcomes of self-monitoring of blood glucose (SMBG) devices along error ranges and strip price. METHODS We programmed a type 1 diabetes natural history and treatment cost-effectiveness model. In phase 1, using past evidence from in silico modeling validated by the Food and Drug Administration, we associated changes in SMBG error to changes in hemoglobin A1c (HbA1c) and separately, changes in severe hypoglycemia requiring an inpatient stay. In phase 2, using Markov cohort simulation modeling, we estimated clinical and economic outcomes from the Canadian payer perspective. The primary comparison was a SMBG device with strip price $0.73 Canadian dollars (CAD) and 10% error (exceeding accuracy requirements by International Organization for Standardization (ISO) 15197:2013) versus a SMBG device with strip price $0.60 CAD and 15% error (accuracy meeting ISO 15197:2013). Outcomes for the average patient, were quality-adjusted life years (QALYs), incremental cost-effectiveness ratios (ICERs), and budget impact. RESULTS Assuming benefits translate into HbA1c improvements only, the ICER with 10% error versus 15% was $11 500 CAD per QALY. Assuming the benefits translate into reduced severe hypoglycemia requiring an inpatient stay only, an SMBG device with 10% error dominated (ie, less costly, more effective) an SMBG device with 15% error. The 3-year budget impact findings ranged from $0.004 CAD per member per month for HbA1c improvements to cost-savings for severe hypoglycemia reductions. CONCLUSIONS From efficiency (cost-effectiveness) and affordability (budget impact) payer perspectives, investing in devices with improved accuracy (less error) appears to be an efficient and affordable strategy.
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Affiliation(s)
- R Brett McQueen
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Marc D Breton
- Center for Diabetes Technology, University of Virginia Health System, Charlottesville, VA, USA
| | - Markus Ott
- Bayer HealthCare, Bayer Inc, Germany and Canada
| | - Helena Koa
- Bayer HealthCare, Bayer Inc, Germany and Canada
| | | | - Jonathan D Campbell
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Abstract
Modeling approaches demonstrate that improvement in the accuracy of blood glucose (BG) meters may lead to cost savings. An improvement of accuracy of BG meters on the basis of a reduction in error range from 20% to 5% has been reported to be associated with substantial cost savings in Germany. The aim of this study is to analyze potential cost savings related to a reduction in error range from 20% to 15% and 10% of glucose meters in Germany. The health economic analysis included the number of type 1 diabetic and the number of insulin-treated patients in Germany, the costs for glucose monitoring, a model on the effects of the improvement of accuracy on the impact of severe hypoglycemic episodes, HbA1c, and subsequently myocardial infarctions and the costs of diabetes-related complications in Germany. In the model, a reduction of 1% and 3.5% reduction in severe hypoglycemic episodes, and a 0.14% and 0.28% reduction in HbA1c was included. In type 1 diabetes the savings could be equal to a reduction in health care expenditures of more than €1.0 million (20% vs 15% error range) and €3.4 million (20% vs 10% error range). Respectively, potential savings of more than €6.0 million and €20.1 million were calculated for the group of insulin-treated patients. The model demonstrates that a reduction of error range of BG meters from 20% to 15% and 10% may translate into substantial savings for the German health care system.
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Affiliation(s)
- Oliver Schnell
- Forschergruppe Diabetes eV, Helmholtz Center Munich, Munich-Neuherberg, Germany
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