FreeStyle Libre boosts testing adherence and lowers costs during MDI treatment, US study reports
The FreeStyle Libre lowers health costs and improves treatment adherence compared with self-monitoring of blood glucoselevels (SMBG), a US study shows.
The Libre and continuous glucose monitors devices measure glucose levels throughout the day, but people are still advised to perform standard blood glucose tests to confirm accuracy, particularly before making any treatment decisions.
Researchers used the findings from the IMPACT (type 1 diabetes) and REPLACE (type 2 diabetes) trials to create a cost calculation based on SMBG testing frequencies of 6-10 per day. This frequency is recommended by The American Diabetes Association for people with diabetes who use MDI.
IMPACT and REPLACE were two six-month studies which compared additional SMBG with the FreeStyle Libre vs. standard SMBG in people on multiple daily injections (MDI),
The study showed that for Libre users with type 1 diabetes and type 2 diabetes who conducted six additional SMBG tests per day the cost was $256 (£193) and $426 (£321) for 10 tests. The monthly sensor cost was $108 (£82). And the calculation also accounted for undiscounted prices on test strips.
Explaining the cost calculation's results, when compared to non-CGM users on SMBG, the researchers said: "For those testing 6 times/day, flash CGM saves over $120 PPPM compared with SMBG and it saves over $290 PPPM for people testing 10 times/day. For people testing more than 3 times/day, flash CGM has a lower acquisition cost than SMBG.
"For people with T1DM or T2DM who use MDI therapy, flash CGM has demonstrated improved adherence to the ADA recommendation as well as reduced acquisition cost when compared with routine SMBG."
The studies also found that Libre users with type 1 diabetes and type 2 diabetes experienced substantial reductions in hypoglycemia compared with SMBG.
In the UK, people with diabetes can purchase the FreeStyle Libre and CGM devices, but it is worth finding out first
The findings were presented at the American Diabetes Association Scientific Sessions and have been published online in the journal Diabetes Care.
Läs Abstract free online
Cost Calculation and Adherence to ADA Recommendations Based on a Flash Continuous Glucose Monitoring System for People with T1DM or T2DM Using MDI Therapy
Background: A novel, factory-calibrated, flash continuous glucose monitoring system (flash CGM; FreeStyle Libre™ system) was approved by FDA in September 2017. The clinical benefit of flash CGM as a replacement for routine self-monitoring of blood glucose (SMBG) for people using MDI therapy has been assessed in RCTs in T1DM (Bolinder, 2016) and T2DM (Haak,2017). In both 6-month studies, people using flash CGM achieved a substantial reduction in hypoglycemia compared with those using SMBG, without increasing HbA1c or reducing the dose of insulin. A cost calculation based on ADA recommendations is presented, comparing the acquisition cost of flash CGM with routine SMBG.
Methods: The ADA Standards of Medical Care in Diabetes (2017) recommend between 6 to 10 glucose tests per day for people with diabetes who are using MDI therapy. List prices are $1.42 per strip and $36.00 per sensor. Sensor duration is up to 10 days. In the T1DM RCT, people using flash CGM also used 0.5 SMBG tests/day on average; in the T2DM RCT, people using flash CGM also used 0.3 SMBG tests/day. The calculation is based on a 30-day month.
Results: Monthly cost of 10 SMBG/day is $426.00 and of 6 SMBG/day is $255.60. This is compared with the monthly sensor cost of $108.00, to which should be added the monthly cost of occasional SMBG based on utilization in the RCTs: $21.30 per person per month (PPPM) for people with T1DM and $12.78 for people with T2DM. For those testing 6 times/day, flash CGM saves over $120 PPPM compared with SMBG and it saves over $290 PPPM for people testing 10 times/day. For people testing more than 3 times/day, flash CGM has a lower acquisition cost than SMBG.
Conclusion: For people with T1DM or T2DM who use MDI therapy, flash CGM has demonstrated improved adherence to the ADA recommendation as well as reduced acquisition cost when compared with routine SMBG.
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