A Budget Impact Model of Switching From Self-Monitoring of Blood Glucose to Continuous Glucose Monitoring for Individuals With Type 2 Diabetes Mellitus Receiving Basal Insulin in Italy
Author(s)
Jessica Yumi Matuoka, PhD1, Marianne van Genugten, MSc2, Marina Grifi, MSc3, Greg Norman, PhD4.
1Dexcom, Inc, San Rafael, CA, USA, 2Dexcom International Ltd., Edinburgh, United Kingdom, 3Dexcom, Morges, Switzerland, 4Dexcom, Inc, San Diego, CA, USA.
1Dexcom, Inc, San Rafael, CA, USA, 2Dexcom International Ltd., Edinburgh, United Kingdom, 3Dexcom, Morges, Switzerland, 4Dexcom, Inc, San Diego, CA, USA.
OBJECTIVES: Keeping glucose levels within range is essential for individuals with type 2 diabetes mellitus (T2DM) on basal insulin. Traditionally, this is done by self-monitoring of blood glucose (SMBG); however, continuous glucose monitoring (CGM) allows for better glucose control and lower risk of hypoglycaemia and hyperglycaemia versus SMBG. The objective of this study was to assess the budget impact of replacing SMBG with CGM in individuals with T2DM on basal insulin, from an Italian healthcare payer perspective.
METHODS: A budget impact model was developed to estimate the economic impact of switching individuals with T2DM on basal insulin from SMBG to CGM over a 5-year time horizon. Clinical data on HbA1c reduction and reductions in hospitalisations for severe hypo- and hyperglycaemia events with CGM versus SMBG, baseline rates for hypo-, and hyperglycaemic hospitalisations were derived from a targeted review of literature. Unit costs, including cost of strips, sensors, acute hospitalisations, and medication costs were derived from Italian sources. All unit costs were inflated to 2024 EUR. One-way sensitivity analysis varying HbA1c reduction, acute hospitalization rates, and unit costs were performed.
RESULTS: From the perspective of the Italian healthcare payer, the acquisition costs of CGM were offset by savings in strip use, hospitalisation costs, doctor visits, and additional medication use (€10,276 per patient per year). This resulted in net savings of €9,326 per patient per year with CGM compared to SMBG. The one-way sensitivity analysis confirmed the robustness of the results. Considering 25,000 individuals with T2DM on basal insulin switching from SMBG to CGM, estimated one-year cost saving was €233,140,265.
CONCLUSIONS: Controlling glucose levels with CGM lowers overall treatment costs in individuals with T2DM on basal insulin. For a disease with rising prevalence and a significant burden, these savings highlight the potential for substantial economic benefit to the Italian healthcare system.
METHODS: A budget impact model was developed to estimate the economic impact of switching individuals with T2DM on basal insulin from SMBG to CGM over a 5-year time horizon. Clinical data on HbA1c reduction and reductions in hospitalisations for severe hypo- and hyperglycaemia events with CGM versus SMBG, baseline rates for hypo-, and hyperglycaemic hospitalisations were derived from a targeted review of literature. Unit costs, including cost of strips, sensors, acute hospitalisations, and medication costs were derived from Italian sources. All unit costs were inflated to 2024 EUR. One-way sensitivity analysis varying HbA1c reduction, acute hospitalization rates, and unit costs were performed.
RESULTS: From the perspective of the Italian healthcare payer, the acquisition costs of CGM were offset by savings in strip use, hospitalisation costs, doctor visits, and additional medication use (€10,276 per patient per year). This resulted in net savings of €9,326 per patient per year with CGM compared to SMBG. The one-way sensitivity analysis confirmed the robustness of the results. Considering 25,000 individuals with T2DM on basal insulin switching from SMBG to CGM, estimated one-year cost saving was €233,140,265.
CONCLUSIONS: Controlling glucose levels with CGM lowers overall treatment costs in individuals with T2DM on basal insulin. For a disease with rising prevalence and a significant burden, these savings highlight the potential for substantial economic benefit to the Italian healthcare system.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE4
Topic
Economic Evaluation, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)