Modelling potential cost savings from use of real-time continuous glucose monitoring in pregnant women with Type 1 diabetes

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AIM: To investigate potential cost savings associated with the use of real-time continuous glucose monitoring (RT-CGM) throughout pregnancy in women with type 1 diabetes.

METHODS: A budget impact model was developed to estimate, from the perspective of National Health Service England, the total costs of managing pregnancy and delivery in women with type 1 diabetes using self-monitoring of blood glucose (SMBG) with and without RT-CGM. It was assumed that the entire modelled cohort (n=1441) would use RT-CGM from 10-38 weeks gestation (7 months). Data on pregnancy and neonatal complication rates and related costs were derived from published literature, national tariffs, and device manufacturers.

RESULTS: The cost of glucose monitoring was £588 with SMBG alone and £1820 with RT-CGM. The total annual costs of managing pregnancy and delivery in women with type 1 diabetes were £23,725,648 with SMBG alone, and £14,165,187 with SMBG and RT-CGM; indicating potential cost savings of approximately £9,560,461 from using RT-CGM. The principal drivers of cost savings were the daily cost of neonatal intensive care unit (NICU) admissions (£3743) and the shorter duration of NICU stay (mean 6.6 vs. 9.1 days respectively). Sensitivity analyses showed that RT-CGM remained cost saving, albeit to lesser extents, across a range of NICU costs and durations of hospital stay, and with varying numbers of daily SMBG measurements.

CONCLUSIONS: Routine use of RT-CGM by pregnant women with type 1 diabetes, would result in substantial cost savings, mainly through reductions in NICU admissions and shorter duration of NICU care. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)1652-1658
Number of pages7
JournalDiabetic Medicine
Issue number12
Early online date4 Jun 2019
Publication statusPublished - Dec 2019

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