Freestyle Libre 2 Flash Glucose Monitoring System: Budget Impact and Cost-Utility Analyses in Type 1 Diabetes from the Italian NHS Perspective

Speaker(s)

Colombo GL1, Torre E2, Di Matteo S3, Monti E2, Martinotti C3, Bruno G4, Levrat Guillen F5
1Pavia University, Pavia, Italy, 2ASL3, Genoa, Italy, Genoa, Italy, 3S.A.V.E. Studi Analisi Valutazioni Economiche, Milan, Italy, 4Bergamo University, Milan, MI, Italy, 5Abbott Diabetes Care, London, UK

Presentation Documents

OBJECTIVES: Budget impact analysis (BIA) and cost-utility analysis (CUA) were conducted from the perspective of Italian healthcare payer to understand the economic impact of the FreeStyle Libre 2 (FSL2) system’s addition in Italy for adults with type 1 diabetes.

METHODS: Analyses were developed in MS Excel. Four glucose monitoring systems were included: self-monitored of blood glucose (BGM), traditional continuous glucose monitoring (CGM), FreeStyle Libre system (FSL), and FSL2. Annual costs included glucose monitoring systems, physician appointments (set up and follow up), healthcare resources consumption. Costs and utilities data came from the Italian National Tariffs and literature. Efficacy of FSL2 on healthcare services utilization came from real-world evidence provided by the RELIEF study. A value-based pricing analysis and one-way deterministic sensitivity analyses were conducted.

RESULTS: Estimated total annual cost per patient was €1,306 with FSL2, €1,176 with FSL, €5,264 with CGM, and €1,009 with BGM. The BIA scenario with the introduction of FSL2, with the following market shares 27%, 50% and 70% respectively after 1, 2 and 3 years, reported a potential cumulative saving of € 145 million over 3 years (€21 million in year 1, €48 million in year 2, €76 million in year 3). CUA provided an ICER of €5,301 for FSL2 vs BGM, €7,116 vs FSL. Compared to CGM, the cost-minimization analysis reported an annual differential cost of €3,958 in favor of FSL2. The sensitivity analyses demonstrated the robustness of the results. Value-based pricing analysis reported an acceptable cost-effectiveness profile for FSL2 (threshold of €25,000 per QALY) up to a sensor unit price increase of €16 vs FSL.

CONCLUSIONS: Reimbursement of FSL2 in Italy for adults with T1DM would result in a consequent decrease in total healthcare spending and would still be considered cost-effective vs FSL with a sensor unit price increase of up to €16.

Code

EE281

Topic

Economic Evaluation, Medical Technologies

Topic Subcategory

Budget Impact Analysis, Cost-comparison, Effectiveness, Utility, Benefit Analysis, Medical Devices, Thresholds & Opportunity Cost

Disease

STA: Medical Devices