medwireNews: Using continuous glucose monitoring (CGM) for all women with type 1 diabetes during pregnancy could save the UK National Health Service (NHS) over 9 million pounds per year, report the CONCEPTT investigators.
Speaking at the Diabetes UK Professional Conference in Liverpool, Helen Murphy (University of East Anglia, Norwich, UK) said that CGM use from 10 to 38 weeks cost £ 1820 (€ 2112, US$ 2374) per woman, compared with £ 588 (€ 682, $ 767) for self-monitored blood glucose (SMBG).
But this cost was offset by reduced hospital costs. Specifically, neonatal hospital stays, at an average cost of £ 347 (€ 403, $ 452) per day, were a median of 3.1 versus 4.0 days for the CGM and SMBG groups, respectively.
Murphy believes that this finding would be important for women, especially those who want to get home to older children, but noted that payers “really didn’t care” because the costs involved were so small.
However, the duration of stay in the neonatal intensive care unit (NICU) – much more expensive at an average of £ 3743 (€ 4344, $ 4879) per day – was also significantly reduced, at a mean of 6.6 versus 9.1 days, in addition to fewer babies in the CGM versus SMBG groups needing to be admitted in the first place.
“This is clearly going to be more relevant to commissioners than a shorter stay on the post-natal ward,” said Murphy.
The team created a budget-impact model based on CONCEPTT costs and outcomes and applied it to 1441 pregnancies from the National Pregnancy In Diabetes audit. This suggested that if all women with type 1 diabetes used CGM during weeks 10–38 of pregnancy, it would save the NHS £ 9,560,461 (€ 11,095,697, $ 12,461,334) per year, mostly due to reduced NICU admissions.
The estimated national annual costs were £ 14,165,187 (€ 16,423,844, $ 18,463,245) with CGM versus £ 23,725,648 (€ 16,423,844, $ 18,445,212) without.
Substantial savings remained in sensitivity analyses including different frequencies of finger-stick testing, length of hospital stays, NICU costs, and intensities of treatment within the NICU.
CGM for all pregnant women with type 1 diabetes is therefore now included in the 10-year NHS plan, said Murphy.
In response to a question from session Chair Anne Dornhorst (Imperial College Hospital, London, UK), she estimated that CGM may not be cost-saving for pregnant women with diabetes, but could be cost-neutral.
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