Cost-effectiveness of a continuous glucose monitoring system with trending and rate information to predict hypoglycaemia and hyperglycaemia in pregnant women with insulin-dependent diabetes mellitus

Summary

This study seeks to determine the cost-effectiveness of the FreeStyle Navigator? continuous glucose monitoring system compared with self-monitoring of blood glucose (SMBG) when predicting hypoglycaemia and hyperglycaemia in pregnant women with insulin-dependent diabetes mellitus. A Markov model was constructed, and initial model analysis demonstrates that use of the FreeStyle Navigator? by a patient who is trained in diabetes management is more cost-effective than SMBG, resulting in an incremental cost-effectiveness ratio of $267 per quality-adjusted life-month ($3,204 per quality-adjusted life-year). The real-time glucose level rate of change and trend information provided by the FreeStyle Navigator? allows appropriately trained patients to improve upon decisions regarding self-treatment to prevent hypoglycaemic and hyperglycaemic episodes, resulting in a lower treatment cost and higher effectiveness than untrained patients. Based on current performance attributes, a device such as the FreeStyle Navigator? would be more cost-effective than other glucose-monitoring devices, meeting the $50,000/QALY willingness-to-pay threshold used by payers for adoption of new technology.