The Cost-Effectiveness of Continuous Glucose Monitoring in Type 1 Diabetes

OBJECTIVE: Continuous glucose monitoring (CGM) has been found to improve glucose control in type 1 diabetic patients. We estimated the cost-effectiveness of CGM versus standard glucose monitoring in type 1 diabetes. RESEARCH DESIGN AND METHODS This societal cost-effectiveness analysis (CEA) was conducted in trial populations in which CGM has produced a significant glycemic benefit (A1C >or=7. 0% in a cohort of adults aged >or=25 years and A1C or=7. 0% cohort: 0. 70 quality-adjusted life-weeks QALWs, P = 0. 49; A1C or=7. 0% cohort, CGM was projected to reduce the lifetime probability of microvascular complications; the average gain in QALYs was 0. 60. The incremental cost-effectiveness ratio (ICER) was 98, 679/QALY (95% CI -60, 000 fourth quadrant to -87, 000 second quadrant). For the A1C <7. 0% cohort, the average gain in QALYs was 1. 11. The ICER was 78, 943/QALY (15, 000 first quadrant to -291, 000 second quadrant). If the benefit of CGM had been limited to the long-term effects of improved glucose control, the ICER would exceed 700, 000/QALY. If test strip use had been two per day with CGM long term the ICER for CGM would improve significantly. CONCLUSIONS: Long-term projections indicate that CGM is cost-effective among type 1 diabetic patients at the 100, 000/QALY threshold, although considerable uncertainty surrounds these estimates.