title: The Potential Cost Implications of Averting Severe Hypoglycemic Events Requiring Hospitalization in High-Risk Adults With Type 1 Diabetes Using Real-Time Continuous Glucose Monitoring.
abstract: Severe hypoglycemia remains a major barrier to optimal diabetes management and places a high burden on the US health care system due to the high costs of hypoglycemia-related emergency visits and hospitalizations. Patients with type 1 diabetes (T1DM) who have hypoglycemia unawareness are at a particularly high risk for severe hypoglycemia, the incidence of which may be reduced by the use of real-time continuous glucose monitoring (RT-CGM).
  
  
  
  We performed a cost calculation using values of key parameters derived from various published sources to examine the potential cost implications of standalone RT-CGM as a tool for reducing rates of severe hypoglycemia requiring hospitalization in adult patients with T1DM who have hypoglycemia unawareness.
  
  
  
  In a hypothetical commercial health plan with 10 million members aged 18-64 years, 9.3% (930 000) are expected to have diagnosed diabetes, with approximately 5% (46 500) having T1DM, of whom approximately 20% (9300) have hypoglycemia unawareness. RT-CGM was estimated to reduce the cost of annual hypoglycemia-related hospitalizations in this select population by $54 369 000, yielding an estimated net cost savings of $8 799 000 to $12 519 000 and a savings of $946 to $1346 per patient.
  
  
  
  This article presents a cost calculation based on available data from multiple sources showing that RT-CGM has the potential to reduce short-term health care costs by averting severe hypoglycemic events requiring hospitalization in a select high-risk population. Prospective, randomized studies that are adequately powered and specifically enroll patients at high risk for severe hypoglycemia are needed to confirm that RT-CGM significantly reduces the incidence of these costly events.
authors.affiliation: AB Medical Communications, Oakland, CA, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Bronstone
authors.affiliation: Dexcom, Inc, San Diego, CA, USA cgraham@dexcom.com.
authors.forename: Claudia
authors.initials: C
authors.lastname: Graham
mesh_terms: D000328:Adult; D015190:Blood Glucose Self-Monitoring / Q000191:economics*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D006760:Hospitalization; D006801:Humans; D007003:Hypoglycemia / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D008962:Models, Theoretical
keywords: cost; hypoglycemia unawareness; model; real-time continuous glucose monitoring; severe hypoglycemia; type 1 diabetes