Cost-Utility Analysis of FreeStyle Libre Systems in People with Type 2 Diabetes Mellitus on Treatment with Basal Insulin and Poor Glycemic Control in Spain

IntroductionFreeStyle Libre (FSL) systems are effective and user-friendly glucose monitoring devices. This cost-effectiveness analysis compared FSL vs. self-blood glucose monitoring (SBGM) in patients with poorly controlled [hemoglobin A1c (HbA1c) > 8%] type 2 diabetes (T2DM) on basal insulin, fr...

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Autores: Robles-Plaza M, Gómez-Peralta F, Bellido V, Ampudia-Blasco FJ, Carretero-Gómez J, Cebrián-Cuenca AM, de la Cuadra-Grande A, Mezquita-Raya P
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p20477
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/20477
Access Level:acceso abierto
Palabra clave:Basal insulin therapy
Cost-effectiveness analysis
Cost-utility analysis
Glucose monitoring
FreeStyle Libre systems
Poor glycemic control
Self-blood glucose monitoring
Spain
Type 2 diabetes mellitus
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spelling Cost-Utility Analysis of FreeStyle Libre Systems in People with Type 2 Diabetes Mellitus on Treatment with Basal Insulin and Poor Glycemic Control in SpainRobles-Plaza MGómez-Peralta FBellido VAmpudia-Blasco FJCarretero-Gómez JCebrián-Cuenca AMde la Cuadra-Grande AMezquita-Raya PBasal insulin therapyCost-effectiveness analysisCost-utility analysisGlucose monitoringFreeStyle Libre systemsPoor glycemic controlSelf-blood glucose monitoringSpainType 2 diabetes mellitusIntroductionFreeStyle Libre (FSL) systems are effective and user-friendly glucose monitoring devices. This cost-effectiveness analysis compared FSL vs. self-blood glucose monitoring (SBGM) in patients with poorly controlled [hemoglobin A1c (HbA1c) > 8%] type 2 diabetes (T2DM) on basal insulin, from the Spanish National Health System perspective. MethodsThe DEDUCE model, which simulated 10,000 patients with T2DM over a 50 years' time horizon (annual discount rate = 3.00%), was adapted to the Spanish setting. The population characteristics, frequency of acute and chronic diabetic complications, costs (<euro>, 2025) and utilities/disutilities proceeded from scientific literature and were validated by national multidisciplinary experts. The annual probabilities of acute events associated with SBGM were 17.02% for non-severe hypoglycemia (SHE) (<euro>3.92; disutility = - 0.0016), 2.50% for SHE (<euro>1031.69; disutility = - 0.0470) and 0.25% for ketoacidosis (DKA) (<euro>2523.93; disutility = - 0.0470). The RECODe risk engine was used to model chronic diabetic complications (myocardial infarction [<euro>1248.44-<euro>31,013.22; disutility = - 0.0550]; heart failure [<euro>1523.14-6505.08; disutility = - 0.1080]; stroke [<euro>3187.92-7849.48; disutility = - 0.1640]; blindness [<euro>2943.37; disutility = - 0.0740]; renal failure [<euro>4057.05-42,757.39; disutility = - 0.2040]). According to the Spanish recommendations, a patient with SBGM required 2.5 reactive strips/day and 2.5 lancets/day (<euro>0.57/strip; <euro>0.14/lancet; VAT included). FSL (26 sensors/year; <euro>3.00/day; VAT included) was associated with reductions of 58% in hypoglycemia, 68% in DKA, 83% in the use of strips/lancets, and an absolute decrease of 1.1% in HbA1c. Deterministic and probabilistic sensitivity analyses (SAs) were conducted. ResultsWhile SBGM yielded 9.18 quality-adjusted life years (QALYs) and total costs of <euro>77,092 (glucose monitoring = <euro>17,080; diabetic complications = <euro>68,272), FSL yielded 9.98 QALYs and total costs of <euro>61,447 (glucose monitoring = <euro>8820; diabetic complications = <euro>44,367). Compared with SBGM, FSL produced total cost savings of <euro>15,645 and 0.80 additional QALYs per patient, being a dominant alternative compared to SBGM. FSL was found to be dominant in all SAs. ConclusionsThis analysis suggests that FSL, which provides better clinical outcomes at a lower overall cost, is a preferable alternative to SBGM among people with poorly controlled T2DM on basal insulin.SPRINGER HEIDELBERG2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/20477Diabetes TherapyISSN: 18696953ISSNe: 18696961reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p204772026-06-07T16:35:31Z
dc.title.none.fl_str_mv Cost-Utility Analysis of FreeStyle Libre Systems in People with Type 2 Diabetes Mellitus on Treatment with Basal Insulin and Poor Glycemic Control in Spain
title Cost-Utility Analysis of FreeStyle Libre Systems in People with Type 2 Diabetes Mellitus on Treatment with Basal Insulin and Poor Glycemic Control in Spain
spellingShingle Cost-Utility Analysis of FreeStyle Libre Systems in People with Type 2 Diabetes Mellitus on Treatment with Basal Insulin and Poor Glycemic Control in Spain
Robles-Plaza M
Basal insulin therapy
Cost-effectiveness analysis
Cost-utility analysis
Glucose monitoring
FreeStyle Libre systems
Poor glycemic control
Self-blood glucose monitoring
Spain
Type 2 diabetes mellitus
title_short Cost-Utility Analysis of FreeStyle Libre Systems in People with Type 2 Diabetes Mellitus on Treatment with Basal Insulin and Poor Glycemic Control in Spain
title_full Cost-Utility Analysis of FreeStyle Libre Systems in People with Type 2 Diabetes Mellitus on Treatment with Basal Insulin and Poor Glycemic Control in Spain
title_fullStr Cost-Utility Analysis of FreeStyle Libre Systems in People with Type 2 Diabetes Mellitus on Treatment with Basal Insulin and Poor Glycemic Control in Spain
title_full_unstemmed Cost-Utility Analysis of FreeStyle Libre Systems in People with Type 2 Diabetes Mellitus on Treatment with Basal Insulin and Poor Glycemic Control in Spain
title_sort Cost-Utility Analysis of FreeStyle Libre Systems in People with Type 2 Diabetes Mellitus on Treatment with Basal Insulin and Poor Glycemic Control in Spain
dc.creator.none.fl_str_mv Robles-Plaza M
Gómez-Peralta F
Bellido V
Ampudia-Blasco FJ
Carretero-Gómez J
Cebrián-Cuenca AM
de la Cuadra-Grande A
Mezquita-Raya P
author Robles-Plaza M
author_facet Robles-Plaza M
Gómez-Peralta F
Bellido V
Ampudia-Blasco FJ
Carretero-Gómez J
Cebrián-Cuenca AM
de la Cuadra-Grande A
Mezquita-Raya P
author_role author
author2 Gómez-Peralta F
Bellido V
Ampudia-Blasco FJ
Carretero-Gómez J
Cebrián-Cuenca AM
de la Cuadra-Grande A
Mezquita-Raya P
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Basal insulin therapy
Cost-effectiveness analysis
Cost-utility analysis
Glucose monitoring
FreeStyle Libre systems
Poor glycemic control
Self-blood glucose monitoring
Spain
Type 2 diabetes mellitus
topic Basal insulin therapy
Cost-effectiveness analysis
Cost-utility analysis
Glucose monitoring
FreeStyle Libre systems
Poor glycemic control
Self-blood glucose monitoring
Spain
Type 2 diabetes mellitus
description IntroductionFreeStyle Libre (FSL) systems are effective and user-friendly glucose monitoring devices. This cost-effectiveness analysis compared FSL vs. self-blood glucose monitoring (SBGM) in patients with poorly controlled [hemoglobin A1c (HbA1c) > 8%] type 2 diabetes (T2DM) on basal insulin, from the Spanish National Health System perspective. MethodsThe DEDUCE model, which simulated 10,000 patients with T2DM over a 50 years' time horizon (annual discount rate = 3.00%), was adapted to the Spanish setting. The population characteristics, frequency of acute and chronic diabetic complications, costs (<euro>, 2025) and utilities/disutilities proceeded from scientific literature and were validated by national multidisciplinary experts. The annual probabilities of acute events associated with SBGM were 17.02% for non-severe hypoglycemia (SHE) (<euro>3.92; disutility = - 0.0016), 2.50% for SHE (<euro>1031.69; disutility = - 0.0470) and 0.25% for ketoacidosis (DKA) (<euro>2523.93; disutility = - 0.0470). The RECODe risk engine was used to model chronic diabetic complications (myocardial infarction [<euro>1248.44-<euro>31,013.22; disutility = - 0.0550]; heart failure [<euro>1523.14-6505.08; disutility = - 0.1080]; stroke [<euro>3187.92-7849.48; disutility = - 0.1640]; blindness [<euro>2943.37; disutility = - 0.0740]; renal failure [<euro>4057.05-42,757.39; disutility = - 0.2040]). According to the Spanish recommendations, a patient with SBGM required 2.5 reactive strips/day and 2.5 lancets/day (<euro>0.57/strip; <euro>0.14/lancet; VAT included). FSL (26 sensors/year; <euro>3.00/day; VAT included) was associated with reductions of 58% in hypoglycemia, 68% in DKA, 83% in the use of strips/lancets, and an absolute decrease of 1.1% in HbA1c. Deterministic and probabilistic sensitivity analyses (SAs) were conducted. ResultsWhile SBGM yielded 9.18 quality-adjusted life years (QALYs) and total costs of <euro>77,092 (glucose monitoring = <euro>17,080; diabetic complications = <euro>68,272), FSL yielded 9.98 QALYs and total costs of <euro>61,447 (glucose monitoring = <euro>8820; diabetic complications = <euro>44,367). Compared with SBGM, FSL produced total cost savings of <euro>15,645 and 0.80 additional QALYs per patient, being a dominant alternative compared to SBGM. FSL was found to be dominant in all SAs. ConclusionsThis analysis suggests that FSL, which provides better clinical outcomes at a lower overall cost, is a preferable alternative to SBGM among people with poorly controlled T2DM on basal insulin.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/20477
url https://incliva.portalinvestigacion.com/publicaciones/20477
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SPRINGER HEIDELBERG
publisher.none.fl_str_mv SPRINGER HEIDELBERG
dc.source.none.fl_str_mv Diabetes Therapy
ISSN: 18696953
ISSNe: 18696961
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
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