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Cost-Effectiveness of a Continuous Glucose Monitoring Mobile App for Patients With Type 2 Diabetes Mellitus: Analysis Simulation

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Title: Cost-Effectiveness of a Continuous Glucose Monitoring Mobile App for Patients With Type 2 Diabetes Mellitus: Analysis Simulation
Authors: Tsuji, Shintaro Browse this author
Ishikawa, Tomoki Browse this author →KAKEN DB
Morii, Yasuhiro Browse this author →KAKEN DB
Zhang, Hongjian Browse this author
Suzuki, Teppei Browse this author
Tanikawa, Takumi Browse this author →KAKEN DB
Nakaya, Jun Browse this author
Ogasawara, Katsuhiko Browse this author →KAKEN DB
Keywords: Markov model
continuous glucose monitoring (CGM)
type 2 diabetes mellitus
incremental cost and effective ratio (ICER)
Issue Date: 17-Sep-2020
Publisher: Journal of Medical Internet Research(JMIR)
Journal Title: Journal of medical internet research
Volume: 22
Issue: 9
Start Page: e16053
Publisher DOI: 10.2196/16053
PMID: 32940613
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. In comparison with conventional retrospective CGM, the use of CGM apps improves patients' own blood glucose control, which is expected to help slow the progression of type 2 diabetes mellitus (DM) and prevent complications, 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 DM, using the probability of developing type 2 DM-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 the cost-effectiveness of the apps. Methods: We developed a Markov model with the transition states of insulin therapy, nephrosis, dialysis, and cardiovascular disease, all of which have a major effect on medical costs, to identify changes in medical costs and utility values resulting from the introduction of a CGM app and calculated the incremental cost-effectiveness ratio (ICER). Results: The ICER for CGM app use was US $33,039/quality-adjusted life year (QALY). Conclusions: Sensitivity analyses showed that, with the exception of conditions where the transition probability of insulin therapy, utility value, or increased medical costs increases, the ICER for the introduction of CGM apps was below the threshold of US $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.
Type: article
Appears in Collections:保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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