COST ANALYSIS OF CONTINUOUS GLUCOSE MONITORING (CGM) POLICY CHANGES IN CAMPANIA, ITALY
Author(s)
Dagna O. Constenla, PhD.
Global HEOR Manager, Abbott, Alameda, CA, USA.
Global HEOR Manager, Abbott, Alameda, CA, USA.
OBJECTIVES: In the Campania region of Italy, reimbursement for the FreeStyle Libre® system (FSL) was temporarily discontinued on 28 February 2023 and replaced with an emerging CGM device. This study assessed the impact of this policy change on diabetes-related costs borne by the Italian National Health Service (NHS) among insulin‑treated adults with type 2 diabetes mellitus (T2DM).
METHODS: This retrospective cohort study used anonymized NHS administrative claims data from Campania. Two 12-month periods were compared: baseline (March 2022-February 2023) and follow-up (December 2023-November 2024). Eligible adults had T2DM, received insulin during the identification period (1 January 2015-28 February 2023), and had evidence of reimbursed FSL use (≥2 sensors/month) during baseline. Adults who died within 21 months of the index date (28 February 2023) were excluded. Mean quarterly NHS-reimbursed diabetes-related costs (drugs/devices, outpatient services, hospitalizations) were compared between baseline and follow-up (quarters 4-7). During follow-up, adults were stratified by reimbursed blood glucose test strip use.
RESULTS: The cohort included 829 adults with T2DM. During the baseline period, individuals were reimbursed for FSL; following the policy change and transition to an emerging CGM device, 23.8% and 11.2% of these adults were occasional and regular strip users, respectively. Mean total quarterly NHS costs increased from €987.75 at baseline to €1,358.93 during follow-up (+37.6%), driven mainly by higher drug costs (+45.8%) and outpatient services (+43.5%); hospitalization costs remained stable. Mean diabetes-related quarterly costs increased by 25.0%, primarily due to diabetes-related drug and outpatient costs. Although regular strip users incurred higher follow-up costs; differences between subgroups were not statistically significant.
CONCLUSIONS: Discontinuation of reimbursed FSL in Campania was associated with increased NHS diabetes-related costs among insulin-treated adults with T2DM, driven mainly by drug and outpatient costs, highlighting the economic impact of CGM reimbursement policy changes.
METHODS: This retrospective cohort study used anonymized NHS administrative claims data from Campania. Two 12-month periods were compared: baseline (March 2022-February 2023) and follow-up (December 2023-November 2024). Eligible adults had T2DM, received insulin during the identification period (1 January 2015-28 February 2023), and had evidence of reimbursed FSL use (≥2 sensors/month) during baseline. Adults who died within 21 months of the index date (28 February 2023) were excluded. Mean quarterly NHS-reimbursed diabetes-related costs (drugs/devices, outpatient services, hospitalizations) were compared between baseline and follow-up (quarters 4-7). During follow-up, adults were stratified by reimbursed blood glucose test strip use.
RESULTS: The cohort included 829 adults with T2DM. During the baseline period, individuals were reimbursed for FSL; following the policy change and transition to an emerging CGM device, 23.8% and 11.2% of these adults were occasional and regular strip users, respectively. Mean total quarterly NHS costs increased from €987.75 at baseline to €1,358.93 during follow-up (+37.6%), driven mainly by higher drug costs (+45.8%) and outpatient services (+43.5%); hospitalization costs remained stable. Mean diabetes-related quarterly costs increased by 25.0%, primarily due to diabetes-related drug and outpatient costs. Although regular strip users incurred higher follow-up costs; differences between subgroups were not statistically significant.
CONCLUSIONS: Discontinuation of reimbursed FSL in Campania was associated with increased NHS diabetes-related costs among insulin-treated adults with T2DM, driven mainly by drug and outpatient costs, highlighting the economic impact of CGM reimbursement policy changes.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
MT2
Topic
Health Policy & Regulatory, Medical Technologies, Real World Data & Information Systems
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)