2368-PUB: Cost Analysis of a Flash Glucose Monitoring System in Type 1 Diabetes Vulnerable Patients, in Spain
Authors: GOMEZ-PERALTA FERNANDO , OYAGÜEZ ITZIAR , MERINO-TORRES JUAN F. , BRITO MIGUEL , MORALES-PEREZ FRANCISCO M. , BELLIDO VIRGINIA , CARDONA-HERNANDEZ ROQUE , CASADO MIGUEL A. 
Published: June 2019

FreeStyle Libre system is a sensor-based flash monitoring (FM) system, which assesses interstitial fluid glucose. The study aimed to estimate the cost associated with FM compared to self-monitoring of blood glucose (SMBG) in a type 1 diabetes mellitus (T1DM) adult population from the Spanish National Health System perspective The annual cost was modeled for glucose monitoring in T1DM with multiple daily insulin (MDI) doses in a vulnerable subgroup, such as disabled patients (blind, Down’s syndrome), patients with repetitive hypoglycemia or pregnancy. For the cost estimation, resource consumption was assessed for glucose monitoring (strips, lancets and FM sensors) and for clinical management of hypoglycemia. Severe hypoglycemia (SHE) and non-severe hypoglycemia (NSHE) published event rates (4.90 and 68.6 episodes/patient/year) were considered. Event reductions associated with FM use were applied (58.6% [SHE]; 32.8% [NSHE]), derived from IMPACT trial findings. Based on published evidence, hospital attendance was required in 20.2% of SHEs (further hospitalization in 16.0%). Additional contact with health professional (HP) was required by 9% of NSHEs cases. Daily strip and lancet-consumption in T1DM vulnerable patients was fixed at 9 for those using SMBG, and at 0.5 in FM users following IMPACT findings. Unitary costs (€,2018 excluding VAT) derived from official databases and literature (€0.28/strip; €0.10/lancet; €45.45/FM sensor; €3,725/hospitalized SHE; €1,758/hospital-attended non-admitted SHE; €253/community attended SHE and €7.17/NSHE requiring additional HP contact) Yearly cost was €4,323 and €2,537 per patient using SMBG or FM, respectively. For a cohort of 1,000 T1DM MDI vulnerable patients; 2,871 SHEs (93 hospitalizations for SHE) and 22,507 NSHEs, yearly could be avoided with FM use. The use of FM in 1,000 patients could generate annual cost-savings up to €1,785,430 compared to SMBG. FM system is a potential cost-saving strategy in T1DM MDI patients in Spain.

Disclosure
F. Gomez-Peralta: Advisory Panel; Self; Abbott, Novo Nordisk A/S, Sanofi. Speaker's Bureau; Self; Abbott, AstraZeneca, Novartis Pharmaceuticals Corporation, Novo Nordisk A/S. I. Oyagüez: None. J.F. Merino-Torres: None. M. Brito: Advisory Panel; Self; Abbott, Merck Sharp & Dohme Corp., Sanofi. Speaker's Bureau; Self; Abbott, Almirall, S.A., Amgen Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Esteve, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Merck Sharp & Dohme Corp., Mylan, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Sanofi. F.M. Morales-Perez: Advisory Panel; Self; Abbott. Research Support; Self; Esteve. Speaker's Bureau; Self; Lilly Diabetes, Medtronic MiniMed, Inc. Other Relationship; Self; AstraZeneca, Esteve, Lilly Diabetes, Novo Nordisk A/S. V. Bellido: None. R. Cardona-Hernandez: None. M.A. Casado: None.

Funding
Abbott Diabetes Care