title: Health State Utilities Associated with Glucose Monitoring Devices.
abstract: BACKGROUND
  Glucose monitoring is important for patients with diabetes treated with insulin. Conventional glucose monitoring requires a blood sample, typically obtained by pricking the finger. A new sensor-based system called "flash glucose monitoring" monitors glucose levels with a sensor worn on the arm, without requiring blood samples.
  
  
  OBJECTIVE
  To estimate the utility difference between these two glucose monitoring approaches for use in cost-utility models.
  
  
  METHODS
  In time trade-off interviews, general population participants in the United Kingdom (London and Edinburgh) valued health states that were drafted and refined on the basis of literature, clinician input, and a pilot study. The health states had identical descriptions of diabetes and insulin treatment, differing only in glucose monitoring approach.
  
  
  RESULTS
  A total of 209 participants completed the interviews (51.7% women; mean age = 42.1 years). Mean utilities were 0.851 ± 0.140 for conventional monitoring and 0.882 ± 0.121 for flash monitoring (significant difference between the mean utilities; t = 8.3; P < 0.0001). Of the 209 participants, 78 (37.3%) had a higher utility for flash monitoring, 2 (1.0%) had a higher utility for conventional monitoring, and 129 (61.7%) had the same utility for both health states.
  
  
  CONCLUSIONS
  The flash glucose monitoring system was associated with a significantly greater utility than the conventional monitoring system. This difference may be useful in cost-utility models comparing the value of glucose monitoring devices for patients with diabetes. This study adds to the literature on treatment process utilities, suggesting that time trade-off methods may be used to quantify preferences among medical devices.
authors.affiliation: Outcomes Research, Evidera, Bethesda, MD, USA. Electronic address: louis.matza@evidera.com.
authors.forename: Louis S
authors.initials: LS
authors.lastname: Matza
authors.affiliation: Outcomes Research, Evidera, Bethesda, MD, USA.
authors.forename: Katie D
authors.initials: KD
authors.lastname: Stewart
authors.affiliation: Actelion Pharmaceuticals, Allschwil, Switzerland.
authors.forename: Evan W
authors.initials: EW
authors.lastname: Davies
authors.affiliation: Global Health Economics, Abbott Diabetes Care, Inc., Alameda, CA, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Hellmund
authors.affiliation: University of California San Diego, San Diego, CA, USA.
authors.forename: William H
authors.initials: WH
authors.lastname: Polonsky
authors.affiliation: William Sansum Diabetes Center, Santa Barbara, CA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Kerr
mesh_terms: D000328:Adult; D001786:Blood Glucose; D015190:Blood Glucose Self-Monitoring / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010865:Pilot Projects; D011788:Quality of Life; D006113:United Kingdom; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: glucose monitoring; medical devices; time trade-off; utility