JMIR Publications

ABSTRACT

Background:

Apps for real-time continuous glucose monitoring (CGM) on smartphones and other devices linked to CGM systems have recently been developed, and such CGM apps are also coming into use in Japan. The use of CGM apps improves patients' own blood glucose control, which is expected to help slow the progression of type 2 diabetes mellitus and prevent complications in comparison with conventional retrospective CGM, but the effect of their introduction on medical costs remains unknown.

Objective:

Our objective in this study was to perform an economic appraisal of CGM apps from the viewpoint of assessing public medical costs associated with type 2 diabetes mellitus, using the probability of developing type 2 diabetes mellitus-associated complications and data on medical costs and utility value to carry out a medical cost simulation using a Markov model in order to ascertain their cost-effectiveness.

Methods:

We developed a Markov model for insulin therapy and nephrosis, dialysis, and cardiovascular disease, all of which have a major effect on medical costs, identified changes in medical costs as a result of the introduction of a CGM app, and calculated the incremental cost-effectiveness ratio (ICER).

Results:

The ICER for CGM application use was $33,039/quality-adjusted life year (QALY).

Conclusions:

Sensitivity analyses showed that with the exception of conditions resulting in increases in the transition probability of insulin therapy, utility value, and increased medical costs, the ICER for the introduction of CGM apps was below the figure of $43,478/QALY used by the Central Social Insurance Medical Council. Our results provide basic data on the cost-effectiveness of introducing CGM apps, which are currently starting to come into use.