OBJECTIVES: As a part of the Danish Health Technology Council’s (DHTC) 2022 health technology assessment concerning glucose monitoring for the treatment of adults with type 1 diabetes an economic evaluation was conducted to evaluate the cost-effectiveness of sensor-based glucose monitors with alarm (‘sensors’) compared with self-monitoring of blood glucose (SMBG).

METHODS: A cost-utility analysis was conducted using a Markov model including 17 health states to reflect the disease progression for a patient cohort with a starting age of 27 and a 6-year history of type 1 diabetes. A lifetime horizon, a one-year cycle-length, and a Danish healthcare sector perspective were applied. Costs were expressed in EUR 2022 (DKK7.46 per EUR), and effectiveness was expressed as quality-adjusted life-years (QALYs). Utility estimates and associated uncertainty were based on EQ-5D values found in the literature. Probabilities and associated uncertainties were likewise retrieved from the literature and confirmed by clinical experts. Costs were primarily based on Danish estimates of resource consumption and prices were provided by distributors of sensors included in the procurement contract with the Danish regions. Cost and outcomes were discounted at 3.5% per year. One-way sensitivity and probabilistic sensitivity analyses were performed to evaluate the robustness of the results.

RESULTS: Over a lifetime horizon, the use of sensors resulted in lower costs (-EUR4,740) and higher effect (1.67QALYs) compared with SMBG. Based on the included uncertainty, there was a 77 % probability of sensors dominating SMBG. Main drivers of costs were the costs associated with sensors and the consumption pattern associated with SMBG. The result was sensitive to the costs of sensors, the association between HbA1c and diabetic late complications, and the time horizon.

CONCLUSIONS: The analysis indicates that sensors dominate SMBG in the Danish healthcare setting. The analysis supported DHTC’s positive recommendation of the use of sensors for adults with type 1 diabetes in Denmark.