Cost of blood glucose test strips outweighs benefits for Type 2 diabetics
MedWire News: The results of two Canadian studies suggest that the economic costs of self-monitoring of blood glucose by Type 2 diabetic patients using test strips outweighs any health benefits gained.
During 2007–2008, blood glucose test strips cost the Ontario Public Drug Programs CAN $100 (€67; US $96.39) million and accounted for 3.3% of all drug expenditure, say researchers.
Muhammad Mamdani (Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Ontario) and team carried out a cross sectional analysis of annual prescription claims for test strips reimbursed by the Ontario Public Drug Program between 1997 and 2008 made by patients aged 65 years or older with diabetes.
They found that the prescription of test strips increased 2.5-fold over the past decade, from 76,320 patients in 1997 to 263,513 in 2008. Of these patients, almost half were at low risk for drug-induced hypoglycemia.
The team reports that over 117 million test strips were actually dispensed in Ontario in 2008, but suggest that a “more focused policy scenario” could reduce this number to between 9.5 and 74.5 million test strips.
A systematic review, carried out by Chris Cameron (Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario) and colleagues, assessed the cost effectiveness of self-monitoring of blood glucose by adults with Type 2 diabetes not taking insulin.
In total, the researchers included seven randomized controlled trials comparing self-monitoring of blood glucose with no self-monitoring comprising 2270 Type 2 diabetic patients treated with oral anti-diabetic agents.
Patients who self-monitored their blood glucose at least seven times per week had 0.25% lower glycated hemoglobin than those who did not, which was estimated to significantly reduce the lifetime incidence of diabetes-related complications.
However, the incremental cost per quality-adjusted life year was estimated to be CAN $113,643 (€76162.89; US $109544.34).
Cameron et al conclude: “For most patients with Type 2 diabetes not using insulin, use of blood glucose test strips for frequent self-monitoring (seven times per week or more) is unlikely to represent efficient use of finite health care resources, although periodic testing (eg, one or two times per week) may be cost-effective.”
Mamdani and team comment: “In light of the overall costs and questionable benefits of blood glucose self-monitoring in many patients, more focused policy decisions regarding test strips have been proposed in several jurisdictions.”
Both studies are published in the Canadian Medical Association Journal.
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By Helen Albert