OBJECTIVES : Compare the differences in diabetes related healthcare expenditure and utilization of using different types of SMBG devices in a cohort of insulin using diabetic patients.

METHODS : A retrospective cohort study was carried out using PharMetrics data from 2010-2014. The claims data provided information on patients’ age, region of residence, health plan, medication filled, diagnoses. The cohort included diabetes patients of age 18-89 years with at least one claim indicating a diagnosis of diabetes. Index date is defined as the prescription of either new SMBG devices (following ISO 2013 accuracy standards) or an old SMBG device (following ISO 2003 accuracy standards). The primary outcome was the differences in diabetes related healthcare utilization across two subgroups. A generalized linear model was used to estimate the outcome of interest.

RESULTS : The cohort included 7622 patients, 1372 using the old device while 6250 were using a new SMBG device. After adjusting the model with propensity scores and other covariates, the overall diabetes related utilization was reduced by 2 % (p-value:0.655) in new user group as compared to the old user group. Diabetes related cost was found to be increased by 7 % (p-value:0.005) in type 1 population as compared to type 2. The cost of diabetes related expenses decreased by 30% (p-value: 0.001) for patients using private insurance. The cost of diabetes also found to be increasing with age, with an approximate increment of >30% (p-value: 0.001) in age group higher than 40 years.

CONCLUSIONS : The improved accuracy of new SMBG devices did not find to make any differences in diabetes related expenditures across the sample. However, this improved accuracy did find to save cost in type 2 diabetes patients as compared to type 1 patients.