ISPOR Europe 2025
9 - 12 November
Cost-Effectiveness Analysis of FreeStyle Libre Systems vs. Self-Monitoring of Blood Glucose in People With Type 2 Diabetes on Basal Insulin: An Israeli Healthcare System Perspective
Author(s)
Dan Greenberg, PhD, MS1, Jack Timmons, PharmD2, Kirk Szafranski, MS3, Fleur Levrat Guillen, PharmD, MS2.
1Ben-Gurion University of the Negev, Beer-Sheva, Israel, 2Abbott Diabetes Care, Alameda, CA, USA, 3EVERSANA, Stoney Creek, ON, Canada.
1Ben-Gurion University of the Negev, Beer-Sheva, Israel, 2Abbott Diabetes Care, Alameda, CA, USA, 3EVERSANA, Stoney Creek, ON, Canada.
Presentation Documents
OBJECTIVES: Growing clinical evidence demonstrates that FreeStyle Libre systems (FSL) is associated with improved glycemic control and reduced diabetes complications and acute events compared to self-monitoring of blood glucose (SMBG) in people with type 2 diabetes (T2D). This study assessed the cost-effectiveness of FSL versus SMBG for people with T2D on basal insulin from the Israeli healthcare system perspective.
METHODS: A patient-level microsimulation, using the validated and published Determination of Diabetes Utilities Costs and Effects Model (DEDUCE) framework, was developed to estimate the cost-effectiveness of FSL versus SMBG for 10,000 individuals with T2D on basal insulin over a lifetime horizon. Annual costs (2024 USD) included device acquisition, diabetes complication management, and acute diabetic events (severe hypoglycemia and diabetic ketoacidosis). Clinical effectiveness was modeled using a 0.5% HbA1c reduction with FSL compared to SMBG, based on real-world evidence. Disutilities were applied to complications and acute events. Costs and outcomes were discounted at 3% annually, with quality-adjusted life-years (QALYs) as the primary outcome.
RESULTS: In the base case analysis, estimated mean total cost was $136,764 for FSL and $120,203 for SMBG. The estimated quality-adjusted life expectancy was 9.4548 for FSL and 9.0544 for SMBG. This yielded an incremental cost-effectiveness ratio (ICER) of $41,357 per QALY gained for FSL vs SMBG. Key model drivers included device acquisition costs and relative HbA1c reduction of FSL vs SMBG. FSL remained cost-effective across scenario analyses with varied parameters.
CONCLUSIONS: Using a willingness-to-pay threshold of $54,191 per QALY (Israel’s 2024 GDP per capita), FSL was cost-effective compared to SMBG for people with T2D on basal insulin. These results are aligned with previously published cost-effectiveness analyses of FSL in this population conducted in other countries.
METHODS: A patient-level microsimulation, using the validated and published Determination of Diabetes Utilities Costs and Effects Model (DEDUCE) framework, was developed to estimate the cost-effectiveness of FSL versus SMBG for 10,000 individuals with T2D on basal insulin over a lifetime horizon. Annual costs (2024 USD) included device acquisition, diabetes complication management, and acute diabetic events (severe hypoglycemia and diabetic ketoacidosis). Clinical effectiveness was modeled using a 0.5% HbA1c reduction with FSL compared to SMBG, based on real-world evidence. Disutilities were applied to complications and acute events. Costs and outcomes were discounted at 3% annually, with quality-adjusted life-years (QALYs) as the primary outcome.
RESULTS: In the base case analysis, estimated mean total cost was $136,764 for FSL and $120,203 for SMBG. The estimated quality-adjusted life expectancy was 9.4548 for FSL and 9.0544 for SMBG. This yielded an incremental cost-effectiveness ratio (ICER) of $41,357 per QALY gained for FSL vs SMBG. Key model drivers included device acquisition costs and relative HbA1c reduction of FSL vs SMBG. FSL remained cost-effective across scenario analyses with varied parameters.
CONCLUSIONS: Using a willingness-to-pay threshold of $54,191 per QALY (Israel’s 2024 GDP per capita), FSL was cost-effective compared to SMBG for people with T2D on basal insulin. These results are aligned with previously published cost-effectiveness analyses of FSL in this population conducted in other countries.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE200
Topic
Economic Evaluation, Health Policy & Regulatory, Medical Technologies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas