PMID- 38001509
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231127
IS  - 1758-5996 (Print)
IS  - 1758-5996 (Electronic)
IS  - 1758-5996 (Linking)
VI  - 15
IP  - 1
DP  - 2023 Nov 25
TI  - Cost-effectiveness of continuous glucose monitoring with FreeStyle Libre((R)) in 
      Brazilian insulin-treated patients with types 1 and 2 diabetes mellitus.
PG  - 242
LID - 10.1186/s13098-023-01208-5 [doi]
LID - 242
AB  - BACKGROUND: Hypoglycemia is a barrier to optimal glucose control in the treatment 
      of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Blood glucose 
      monitoring is essential in diabetes management. Inappropriate glucose management 
      is associated with high mortality and morbidity. FreeStyle Libre((R)) (FSL) is a 
      continuous glucose monitoring (CGM) system that provides effective, safe, and 
      convenient glucose monitoring, without routine finger pricking. This study aims 
      to estimate the incremental cost-effectiveness ratio (ICER) of the FSL system in 
      comparison to conventional Self-monitoring of blood glucose (SMBG) in T1DM and 
      T2DM patients that require intensive insulin therapy. METHODS: A decision-tree 
      model was developed to compare the cost-effectiveness ratio between FSL and 
      conventional SMBG from the perspective of the Brazilian Public Healthcare System 
      (SUS). The model captures the cumulative rates of acute complications such as 
      severe hypoglicemia and diabetic ketoacidosis, per-event costs, and 
      quality-adjusted life-years (QALYs) gained over a 1-year time horizon in adult 
      and pediatric patients (>/= 4 years old) with T1DM or T2DM. Inputs from the 
      Brazilian health databases, clinical trials, and real-world data were used in the 
      study. RESULTS: The results demonstrated that, regarding solely severe 
      hypoglicemia and diabetic ketoacidosis events, T1DM have a QALY difference of 
      0.276, a cost difference of R$ 7.255, and an ICER of R$ 26,267.69 per QALY gained 
      for CGM with FSL, when compared to conventional SMBG. T2DM results demonstrated 
      equally a QALY difference of 0.184, a cost difference of R$ 7290, and an ICER of 
      R$ 39,692.67 per QALY gained, in favour of CGM with FSL. CONCLUSION: Our findings 
      demonstrated that FSL is cost-effective in T1DM and T2DM for acute diabetic 
      complications, from a SUS perspective. CGM with FSL can promote safe, convenient, 
      and cost-effective glucose monitoring, therefore contributing to the improvement 
      of the incidence of complications and quality of life.
CI  - (c) 2023. The Author(s).
FAU - Bahia, Luciana
AU  - Bahia L
AUID- ORCID: 0000-0001-6433-5967
AD  - Brazilian Diabetes Society, Sao Paulo, Brazil. lucianabahia@gmail.com.
FAU - Mello, Karla F
AU  - Mello KF
AUID- ORCID: 0000-0003-0096-2325
AD  - Brazilian Diabetes Society, Sao Paulo, Brazil.
FAU - Lemos, Livia Lovato Pires
AU  - Lemos LLP
AUID- ORCID: 0000-0002-8921-515X
AD  - IQVIA, Real World Insights, Sao Paulo, Brazil.
FAU - Costa, Naiane Lima
AU  - Costa NL
AUID- ORCID: 0000-0001-6675-2668
AD  - IQVIA, Real World Insights, Sao Paulo, Brazil.
FAU - Mulinari, Eduardo
AU  - Mulinari E
AUID- ORCID: 0009-0006-6447-7512
AD  - IQVIA, Real World Insights, Sao Paulo, Brazil.
FAU - Malerbi, Domingos A
AU  - Malerbi DA
AUID- ORCID: 0000-0002-7802-5983
AD  - Brazilian Diabetes Society, Sao Paulo, Brazil.
LA  - eng
PT  - Journal Article
DEP - 20231125
PL  - England
TA  - Diabetol Metab Syndr
JT  - Diabetology & metabolic syndrome
JID - 101488958
PMC - PMC10675900
OTO - NOTNLM
OT  - Cost-effectiveness
OT  - Glucose monitoring
OT  - Type 1 Diabetes mellitus
OT  - Type 2 Diabetes mellitus
COIS- LLPL, NLC and EM are employees of IQVIA. The remaining authors declare that they 
      have no competing interests.
EDAT- 2023/11/25 12:45
MHDA- 2023/11/25 12:46
PMCR- 2023/11/25
CRDT- 2023/11/24 23:52
PHST- 2023/07/29 00:00 [received]
PHST- 2023/11/02 00:00 [accepted]
PHST- 2023/11/25 12:46 [medline]
PHST- 2023/11/25 12:45 [pubmed]
PHST- 2023/11/24 23:52 [entrez]
PHST- 2023/11/25 00:00 [pmc-release]
AID - 10.1186/s13098-023-01208-5 [pii]
AID - 1208 [pii]
AID - 10.1186/s13098-023-01208-5 [doi]
PST - epublish
SO  - Diabetol Metab Syndr. 2023 Nov 25;15(1):242. doi: 10.1186/s13098-023-01208-5.