Costes y efectividad de un detector de tendencias glucémicas en pacientes con diabetes mellitus

Objective

To estimate the cost, outcome and economic impact, of the use of a Blood Glucose Monitoring System (BGMS) with pattern alert technology compared with standard BGMS, for the prevention of severe hypoglycemia (SH) in the insulin-treated type 1 and type 2 diabetes populations.

Material and methods

A short term model has been constructed from literature data. It has been assumed that the cost of both BGMS and their corresponding strips are identical between alternatives, including only the direct cost of the severe hypoglycemia event caused by poor metabolic control.

Results

BGMS shows low sensitivity and positive predictive value, and high specificity and negative predictive value. With a baseline risk of hypoglycemia of around 9% for the insulin-treated DM1 and DM2 population, and 17% for DM1 population < 17 years, the trend detector algorithm could prevent between 20% and 35% of severe hypoglycemias. Cost saving per patient would be between € 12 and € 39, respectively. Moreover, this monitoring system could save costs of around € 7.7 million € for the Health System in a baseline analysis.

Conclusions

BGMS with pattern alert technology is effective in preventing severe hypoglycemia and can be cost saving for Spanish health system. Nevertheless, empirical data on the probability of reducing Severe Hypoglycemia is necessary in order to reach any firm conclusions.