Cost‐effectiveness analysis comparing real‐time continuous glucose monitoring with self‐monitoring of blood glucose for patients with type 2 diabetes treated with insulin in Japan

ABSTRACT Introduction Real‐time continuous glucose monitoring (rt‐CGM) systems are associated with reductions in glycated hemoglobin (HbA1c) and hypoglycemic events compared with self‐monitoring of blood glucose (SMBG). This analysis aimed to assess the cost‐effectiveness of rt‐CGM compared with SMBG in the management of people with T2D who require insulin treatment in Japan. Materials and Methods A lifetime economic evaluation was conducted using the IQVIA Core Diabetes Model, version 10. Effectiveness data were obtained from a randomized controlled trial that showed rt‐CGM reduced HbA1c by 0.9% compared to SMBG. Cohort characteristics and cost data were primarily sourced from Japanese studies. Costs were inflated to 2023 Japanese Yen (JPY) and discounted at 2.0% per annum. The robustness of the base case results was subsequently assessed through sensitivity analyses. Results In the base case, there was an incremental gain of 1.501 quality‐adjusted life years (QALYs) favoring rt‐CGM at an incremental cost of JPY 500,192, resulting in an incremental cost‐effectiveness ratio (ICER) of JPY 333,150/QALY gained. This was far below the assumed willingness‐to‐pay (WTP) threshold of JPY 5,000,000/QALY gained. The result was robust in sensitivity analyses, with all scenarios tested also returning ICERs below the WTP threshold. When examining projected clinical outcomes, rt‐CGM was associated with reductions in the incidence of the majority of complications considered. Conclusions From a Japanese healthcare perspective, rt‐CGM is highly cost‐effective for the glycemic management of people with T2D who require insulin treatment.