OBJECTIVES: In patients with diabetes mellitus type II (DMII), 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 in the point-of-care setting (POC) in mid-income countries Brazil and Serbia.

METHODS: We developed budget impact model (BIM) comparing the strategy of POC HbA1c monitoring with the strategy of conventional laboratory diagnostics (LD) HbA1c monitoring in patients suffering from DMII. BIM was based on the results of the study which has shown that POC is more efficacious in reducing HbA1c level than LD with the difference of 1% over a 7-year period. Using BIM, we followed a cohort of patients diagnosed with DMII in Brazil and Serbia for the period of 15 years and estimated the HbA1c test costs, HbA1c test follow-up 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 DMII, POC HbA1c monitoring resulted in the average saving of €117 per patient in the cohort in Brazil and €360 in Serbia when compared to conventional LD monitoring. The main contributor to the saving were lower HbA1c follow-up test costs 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 DMII may reduce diabetes-related heath care costs in high-income countries. This study has important potential implications for management of the diabetic population and reimbursement of HbA1c testing methodologies in mid-income countries as well.