Introduction and Objective: The use of RT-CGM improves glycemic outcomes in people with insulin-treated T2D, including basal insulin users. We investigated the cost-effectiveness of Dexcom ONE+ RT-CGM from the Italian healthcare payer perspective. Methods: We used the IQVIA Core Diabetes Model v10.0 to project clinical outcomes and direct medical costs over a lifetime horizon from the Italian healthcare payer perspective. Cohort characteristics were sourced from the Italian Association of Medical Diabetologists and other studies. Clinical inputs were sourced from a large US retrospective cohort study. An A1C change of -0.56% favoring RT-CGM, severe hypoglycemic event changes of -69% and +22% for RT-CGM and SMBG, respectively, and DKA rate changes of -66% and 0%, respectively, were assumed. The cost of RT-CGM was based on Dexcom ONE+ local pricing, while SMBG costs were based on the Italy tender price for 3.8 tests/day. Utilities for the avoidance of finger sticks (0.03) and fear of hypoglycemia reduction (0.0155) were applied to RT-CGM users. Results: The model projects RT-CGM users to have higher quality-adjusted life years (QALY) by 0.577 with incremental costs of €996, and an incremental cost-effectiveness ratio of €1,727/QALY gained, which is below the willingness-to-pay threshold of €30,000/QALY gained. RT-CGM was highly cost-effective across several scenarios, and it became dominant when earlier RT-CGM initiation and 6+ SMBG tests/day were assumed. The projected relative reduction of incident kidney, eye, neuropathy, and cardiovascular complications with RT-CGM use was 18.9%, 16.6%, 7.8%, and 2.5%, respectively. Total lifetime cost savings were estimated at €4,195 per person. Conclusion: Dexcom ONE+ RT-CGM is highly cost-effective and projects cost savings due to reductions in acute diabetes events and micro- and macrovascular complications. Our findings support expanding RT-CGM reimbursement to all insulin users in Italy. Disclosure F. Giorgino: Advisory Panel; Current; Abbott. Consultant; Current; Lilly, Novo Nordisk. Advisory Panel; Current; AstraZeneca, Medtronic. Research Support; Current; Roche Diabetes Care. Advisory Panel; Current; LifeScan, Sanofi. Advisory Panel; Ended; Merck Sharp Current; Boehringer Ingelheim International GmbH. J. Matuoka: Employee; Current; Dexcom, Inc. Stock/Shareholder; Current; Dexcom, Inc. L. Laviola: Speaker's Bureau; Ended; A. Menarini Diagnostics, Abbott. Advisory Panel; Ended; Boehringer Ingelheim International GmbH, Eli Lilly and Company. Speaker's Bureau; Ended; Eli Lilly and Company. Research Support; Current; Medtronic. Speaker's Bureau; Ended; Medtronic. Advisory Panel; Ended; Novo Nordisk. Speaker's Bureau; Ended; Novo Nordisk. Advisory Panel; Ended; PIKDARE S.p.A., Roche Diabetes Care, Roche Diagnostics, Sanofi. G. Norman: Employee; Current; Dexcom, Inc. Stock/Shareholder; Current; Dexcom, Inc.
GIORGINO et al. (Fri,) studied this question.