Abstract
AIMS: Real-time continuous glucose monitors (rt-CGM) have been found effective and economical for the treatment of diabetes in many countries. The objective of this study was to provide a cost-effectiveness analysis of rt-CGM versus self-monitoring of blood glucose (SMBG) from the perspective of a healthcare payer in New Zealand. MATERIALS AND METHODS: The cost-effectiveness of rt-CGM in patients with type 2 diabetes (T2D) who require intensive insulin therapy was analysed using the IQVIA Core Diabetes Model (CDM), providing outputs including life expectancy, quality-adjusted life years (QALYs), direct costs, incremental cost-effectiveness ratios (ICERs), and incidence rates of complications. A lifetime (50 years) time horizon was used with an annual discount rate of 3.5%. RESULTS: In the base case, rt-CGM was associated with a gain of 0.488 QALYs and incremental costs of NZD 5633 compared with SMBG, resulting in an ICER of NZD 11 533 per QALY. This corresponded to a gain of 87 QALYs per NZD 1 million invested. Scenario analyses suggested that CGM is potentially cost saving at earlier ages of rt-CGM initiation and among high-risk populations, such as Māori and Pacific Peoples, yielding higher gains in QALYs at lower total direct costs. Reductions were predicted in the risks of ophthalmic, renal, peripheral, and cardiovascular complications. CONCLUSIONS: This analysis provides insight into the cost-effectiveness of rt-CGM versus SMBG from the perspective of payers in New Zealand, demonstrating reductions in the risks of complications in addition to reductions in their associated costs.