Cost-effectiveness of use of the GlucoWatch Biographer in children and adolescents with type 1 diabetes: a preliminary analysis based on a randomized controlled trial.
OBJECTIVE
To conduct a preliminary analysis of the cost-effectiveness of the use of the GlucoWatch Biographer in the management of type 1 diabetes in children and adolescents.


METHODS
The computer model used to analyze the cost-effectiveness of intensive diabetes treatment in the Diabetes Control and Complications Trial (DCCT) was modified to simulate cohorts of patients who participated in a small clinical trial at one center comparing standard and Biographer-assisted standard care. The model is a Monte Carlo simulation model that simulates the lives of individual patients. Cohorts of 10,000 patients are simulated to accumulate statistics on average treatment costs and complications. Complication and treatment costs were updated to 2002 dollars. Future costs and benefits are discounted using a rate of 3%. The perspective of the analysis is from a single payer of health care costs.


RESULTS
The model predicts that use of the Biographer, if sustained for the life of the cohort, would delay the development of the first serious diabetes complication by 4.1 yr. Treating 18 subjects would prevent one case of blindness and 1.4 cases of renal failure. The intervention costs $91,059/years-of-life (YOL), $61,326/quality-adjusted life-years (QALYs), and $9930/yr free of a major complication. If the biographer ceased to be effective after age 17, the cost per QALY would increase to $103,178/QALY gained.


CONCLUSIONS
Preliminary analysis of the cost-effectiveness of use of the GlucoWatch Biographer in diabetes management is encouraging. Definitive analysis will require confirmation in other studies and populations.
Eastman
Richard C
RC
Cygnus, Inc., 400 Penobscot Drive, Redwood City, California 94063, USA. reastman@cygn.com
Leptien
Amy D
AD
Chase
H Peter
HP
D000293:Adolescent; D001766:Blindness / Q000453:epidemiology / Q000517:prevention & control; D002648:Child; D003120:Colorado; D003362:Cost-Benefit Analysis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000517:prevention & control; D008268:Macular Degeneration / Q000453:epidemiology / Q000517:prevention & control; D008499:Medical Records / Q000191:economics*; D013997:Time Factors