Introduction and Objective: This cost analysis compared FreeStyle Libre® systems (FSL) vs self-monitoring of blood glucose (SMBG) in T2D patients on basal insulin and poorly controlled (HbA1c > 8%), from a societal perspective in Spain.Methods: A model compared costs (€2024) of FSL and SMBG in a cohort of 1,000 T2D patients. The inputs, validated by local experts, derived from literature. Acute events in SMBG were modeled by event frequency and costs/patient-year (events/year-patient [cost]: mild hypoglycemia [MH] = 17.0 [€17]; severe hypoglycemia events [SHE] = 2.5 [€2,509]; DKA = 0.03 [€2,071]). Chronic complications were modeled by frequency and 1% decrease in HbA1c-related risk reduction (% events [% risk reduction / cost]: AMI = 7.4 [14.0 / €1,214]; angina pectoris = 8.6 [9.9 / €670]; HF = 6.3 [16.0 / €1,482]; stroke = 3.6 [12.0 / €3,101]; transitory ischemic disease = 3.6 [12.0 / €2,774]; neuropathy = 5.3 [37.0 / €3,961]; retinopathy = 8.1 [19.0 / €3,845]; peripheric angiopathy = 5.0 [16.7 / €1,086]; nephropathy = 8.6 [21.9 / €1,884]; ESRD = 5.9 [21.9 / €41,593]). Absenteeism in employed patients (26.5%) was determined by an absenteeism rate of 18.5% (64.6 days lost/patient-year, average earnings €26,700/year). Daily SMBG use included 2.5 strips (€0.55/unit) and 2.5 lancets (€0.14/unit). FSL reduced acute events (MH/SHE by 58%; DKA by 68%), HbA1c levels (1.1%), absenteeism (58.4%), and strip/lancet use (83%).Results: Annual cost/patient was €7,085 for SMBG and €5,172 for FSL. For 1,000 patients, FSL averted 9,872 MHs, 1,450 SHEs, 2 DKAs, 124 chronic complications, and 1,850 absenteeism days. Total savings were €1,913,489 (€135,200 from reduced absenteeism). Sensitivity analyses confirmed cost savings.Conclusion: Compared to SMBG, FSL reduce diabetic complications and absenteeism in poorly controlled T2D patients on basal insulin, generating cost savings for the Spanish healthcare system and society.
F. Ampudia Blasco: Consultant; Abbott. Speaker’s Bureau; Abbott. I. Oyagüez: None. P. Mezquita-Raya: Consultant; Abbott. A. Hernández Martínez: Consultant; Abbott. A. Cebrian: None. J. Carretero Gomez: None. V. Bellido: Speaker’s Bureau; Novo Nordisk, Lilly Diabetes, Sanofi, AstraZeneca, Abbott. Consultant; Novo Nordisk, Sanofi, Abbott. Research Support; Novo Nordisk, Sanofi, Lilly Diabetes. F. Gomez-Peralta: Speaker’s Bureau; Abbott. Advisory Panel; Novo Nordisk. Speaker’s Bureau; Lilly Diabetes, Sanofi, Menarini.
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