Cost–utility analysis of Dexcom G6 real-time continuous glucose monitoring versus FreeStyle Libre 1 intermittently scanned continuous glucose monitoring in adults with type 1 diabetes in Belgium
Authors' conclusion
When priced similarly, Dexcom G6 rtCGM with alert functionality has both economic and clinical benefits compared with FreeStyle Libre 1 isCGM without alerts in adults with type 1 diabetes in Belgium, and appears to be a cost-effective glucose monitoring modality.
Study context
- Population
- Adults with T1D in Belgium; simulated cohort from the randomised ALERTT1 trial; age 42.9 ± 14.1 years, baseline HbA1c 57.8 ± 9.5 mmol/mol (7.4 ± 0.9%)simulated cohort
- Comparison
- Dexcom G6 real-time continuous glucose monitoring (rtCGM) with alerts vs FreeStyle Libre 1 intermittently scanned continuous glucose monitoring (isCGM) without alerts
- Outcome
- Long-term cost-effectiveness (health outcomes as quality-adjusted life years)
- Follow-up
- Lifetime time horizon
Methodological detailsIQVIA CORE Diabetes Model, Belgian healthcare payer perspective, lifetime time horizon, probabilistic and one-way sensitivity analyses, Model input: rtCGM HbA1c reduction of 3.6 mmol/mol (0.36 percentage points), 6-month mean between-group difference, Base-case price €3.92/day for both (excluding VAT), Belgian reimbursement system
- IQVIA CORE Diabetes Model
- Belgian healthcare payer perspective
- Lifetime time horizon
- Probabilistic and one-way sensitivity analyses
- Model input: rtCGM HbA1c reduction of 3.6 mmol/mol (0.36 percentage points), 6-month mean between-group difference
- Base-case price €3.92/day for both (excluding VAT), Belgian reimbursement system
Main finding
As reported in the abstract
Cost-effectiveness, base case (both priced €3.92/day) · lifetime
- rtCGM dominated isCGM: lower diabetes-related complication costs and better health outcomes
- Main drivers favouring rtCGM: lower HbA1c, fewer severe hypoglycaemic events, reduced fear of hypoglycaemia
Further findings
One-way sensitivity analyses
- Results robust under a wide range of one-way sensitivity analyses
Price scenarios for rtCGM
- rtCGM cost-neutral at €5.11/day (price increase of 30.4%)
- ICER of €40,000 per quality-adjusted life year at €12.34/day (price increase of 214.8%)
Original publication
Cost–utility analysis of Dexcom G6 real-time continuous glucose monitoring versus FreeStyle Libre 1 intermittently scanned continuous glucose monitoring in adults with type 1 diabetes in Belgium. Diabetologia. Published 18 January 2024. doi:10.
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