OBJECTIVES: In patients with non-insulin-dependent diabetes mellitus type II (T2DM), efficient monitoring of glycated hemoglobin (HbA1c) level is essential in ensuring glycemic control. In this study, we assessed the overall budget impact of HbA1c monitoring of patients with non-insulin-dependent T2DM in the point-of-care setting (POC) in Russia.

METHODS: We developed budget impact model (BIM) comparing the strategy of POC HbA1c monitoring every 3 months with the current standard of care strategy which consists of HbA1c testing performed twice a year. BIM was based on the results of the study which has shown that consistent POC-based HbA1c monitoring every 3 months leads to the difference of 1% over a 7-year period. Using BIM, we followed a cohort of patients diagnosed with T2DM in Russia for the period of 15 years and estimated the HbA1c test costs, and costs of complications (amputation, cataract extraction, kidney failure, heart failure, stroke, and microvascular disease) using the local data. All costs were expressed in €.

RESULTS: In patients with non-insulin-dependent T2DM, POC HbA1c monitoring every 3 months results in the average saving of €42 per patient in the cohort in Russia when compared to the standard of care. The main contributor to the saving were lower complication costs due to better diabetes control in the POC methodology.

CONCLUSIONS: Findings of our study corroborate those of our earlier studies, where we have shown that the POC HbA1c monitoring in patients suffering from T2DM may reduce diabetes-related heath care costs in high-income and middle-income countries. This study has important potential implications for management of the diabetic population and reimbursement of HbA1c testing methodologies in Russia as well.