Evaluating the cost-effectiveness of self-monitoring of blood glucose in type 2 diabetes patients on oral anti-diabetic agents

Abstract

OBJECTIVES: To evaluate the cost-effectiveness of self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes treated with oral anti-diabetic agents (OADs) in Switzerland. METHODS: A validated computer model of diabetes was used to project outcomes reported from a published longitudinal study of SMBG in type 2 diabetes patients, treated with OADs and with no history of SMBG, over a 30-year time horizon and cost-effectiveness was assessed from the perspective of a third party healthcare payer. Costs and clinical outcomes were discounted at 3% annually in line with recommended practice. Sensitivity analyses were performed. RESULTS: Once, twice or three times daily SMBG was associated with improvements in HbA1c which led to increased life expectancy and quality-adjusted life expectancy, and reduced incidence of diabetes complications compared with no SMBG in type 2 diabetes patients on OADs. Direct medical costs increased by CHF 528, CHF 1'650 and CHF 2'899 in patients performing SMBG once, twice or three times daily compared to those not using SMBG, respectively. Incremental cost-effectiveness ratios were well below commonly quoted willingness-to-pay thresholds at CHF 9'177, CHF 12'928 and CHF 17'342 per quality-adjusted life year (QALY) gained respectively. CONCLUSIONS: Based on data from a large observational study, SMBG is likely to be cost-effective by generally accepted standards in SMBG-naïve patients on oral anti-diabetic agents in the Swiss setting.

Keywords

• blood glucose
• Diabetes
• Self-monitoring
• SMBG