THE COST-EFFECTIVENESS OF CONTINUOUS GLUCOSE MONITORING (CGM) FOR ADULTS WITH TYPE 1 DIABETES IN IRELAND
Author(s)
Gintare Valentelyte, PhD1, Jonathan Briody, PhD1, Kevin McIntyre, PhD1, Liam Manning, MD2, Seamus Sreenan, MB2, Edward E. Gregg, PhD1;
1RCSI University of Medicine and Health Sciences, Converge: Centre for Chronic Disease and Population Health Research, School of Population Health, Dublin, Ireland, 2Connolly Hospital, Blanchardstown, Dublin, Ireland
1RCSI University of Medicine and Health Sciences, Converge: Centre for Chronic Disease and Population Health Research, School of Population Health, Dublin, Ireland, 2Connolly Hospital, Blanchardstown, Dublin, Ireland
OBJECTIVES: Continuous Glucose Monitoring (CGM) improves glucose control in adults with type 1 diabetes. In 2024 CGM was nationally rolled out for all individuals living with type 1 diabetes in Ireland. We estimated the lifetime cost-effectiveness of CGM for adults with type 1 diabetes in Ireland, using a validated diabetes cost-effectiveness model.
METHODS: We adapted the U.S. Centers for Disease Control and Prevention-RTI Diabetes Cost-Effectiveness Model to an Irish cohort living with type 1 diabetes. In this microsimulation model, we estimated the costs, quality-adjusted life-years (QALYs) and cost-effectiveness of CGM as an intervention relative to usual diabetes care i.e. self-monitoring of blood glucose (SMBG). In this microsimulation model, CGM may lead to reductions in other related complications, which we also modelled. Costs were considered from the Irish health care system’s perspective. An annual discount rate of 4% was applied to future costs and outcomes. Uncertainty was evaluated using probabilistic sensitivity analysis.
RESULTS: CGM was cost-effective relative to SMBG at the incremental cost-effectiveness ratio (ICER) of €36,087 per QALY gained. CGM was associated with a mean incremental gain in 0.05 QALYs and total mean costs of €229,152, compared to SMBG total mean costs of €227,293. Most simulations were below the commonly accepted willingness-to-pay threshold of €45,000 per QALY gained in Ireland. Additionally, CGM led to an average reduction in the share of patients with the associated complications and reduced incidence of many type 1 diabetes-related complications, compared to SMBG. Sensitivity analyses indicated that the results were sensitive to costs and influenced by the age of the population.
CONCLUSIONS: This study provides timely robust evidence to support that nationally subsidised roll-out of CGM for the entire population living with type 1 diabetes in Ireland is cost-effective leading to improved health outcomes.
METHODS: We adapted the U.S. Centers for Disease Control and Prevention-RTI Diabetes Cost-Effectiveness Model to an Irish cohort living with type 1 diabetes. In this microsimulation model, we estimated the costs, quality-adjusted life-years (QALYs) and cost-effectiveness of CGM as an intervention relative to usual diabetes care i.e. self-monitoring of blood glucose (SMBG). In this microsimulation model, CGM may lead to reductions in other related complications, which we also modelled. Costs were considered from the Irish health care system’s perspective. An annual discount rate of 4% was applied to future costs and outcomes. Uncertainty was evaluated using probabilistic sensitivity analysis.
RESULTS: CGM was cost-effective relative to SMBG at the incremental cost-effectiveness ratio (ICER) of €36,087 per QALY gained. CGM was associated with a mean incremental gain in 0.05 QALYs and total mean costs of €229,152, compared to SMBG total mean costs of €227,293. Most simulations were below the commonly accepted willingness-to-pay threshold of €45,000 per QALY gained in Ireland. Additionally, CGM led to an average reduction in the share of patients with the associated complications and reduced incidence of many type 1 diabetes-related complications, compared to SMBG. Sensitivity analyses indicated that the results were sensitive to costs and influenced by the age of the population.
CONCLUSIONS: This study provides timely robust evidence to support that nationally subsidised roll-out of CGM for the entire population living with type 1 diabetes in Ireland is cost-effective leading to improved health outcomes.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE325
Topic
Economic Evaluation
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)