Real-Time CGM Use Associated with Reduced Medical Costs in Patients with Type 2 Diabetes

Gregory Norman, PhD

A study examining the impact of real-time continuous glucose monitoring (CGM) has returned results suggesting use of real-time CGM was associated with decreased diabetes-related expenses among patients with type 2 diabetes.

While many studies have detailed the impact of real-time CGM on outcomes or time-in-range among patients with type 2 diabetes, the current study, which was presented at the American Diabetes Association’s 81st Scientific Sessions (ADA 2021), demonstrates use of real-time CGM was associated with a mean reduction in spending per-person-per-month of $424.

“This study provides real-world evidence that real-time CGM use was associated with reductions in diabetes-related medical costs for people with type 2 diabetes. Increased access to real-time CGM may help reduce diabetes-related costs of care,” said Gregory Norman, PhD, an Adjunct Professor at the University pf California, San Diego and the Director of Health Economics and Outcomes Research with Dexcom, during his presentation at ADA 2021.

As the popularity of real-time CGM continues to increase, the research emphasis on these devices has begun to shift from outcomes to impact on medical costs and quality of life among patients using the technology. With this in mind, Norman and a team of colleagues designed the current study as a retrospective analysis of administrative claims data from within the Optum Research Database with the aim of assessing how implementation of real-time CGM might influence diabetes-related medical costs.

For the purpose of analysis, investigators sought to identify patients who initiated real-time CGM between October 2017-February 2019. Index date was defined as the earliest observed use of real-time CGM. To be eligible for inclusion, patients needed to be commercial or Medicare Advantage beneficiaries, have no evidence of pregnancy or type 1 diabetes in the year prior to index date, and have 1 or more claims with real-time CGM during the identification.

Investigators noted patients were required to be continuously insured for at least 1 year prior to index date and needed at least 6 months of follow-up data after beginning real-time CGM. The primary outcomes of interest were the total diabetes-related costs during the baseline and follow-up periods as well as the change in per-person-per-month costs, which was assessed using paired t-tests.

In total, 571 patients were identified for inclusion. This cohort had a mean age of 51.2 (SD, 11.9) years, 46% were female, 99% had commercial insurance, 80% were treated with intensive insulin therapy, 58% were seeing an endocrinologist, and 92% reported having comorbidity complications. In the year prior to initiating real-time CGM therapy, the mean per-person-per-month cost associated with diabetes management was $1680 (SD, $4519) compared to $1256 (SD, $3679) after starting real-time CGM. This equated to a reduction of $424 per-person-per-month in diabetes-related costs after initiating real-time CGM (95% CI, -816 to -31; P=.034).

Further analysis suggested the majority of this reduction was driven by reductions in diabetes-related inpatient medical costs (-$358; 95% CI, -706 to -10; P <.044) Investigators also pointed out the mean number of inpatient hospital stays and days spent hospitalized were reduced by -0.42 days per-person-per-month.

This study, “Real-Time Continuous Glucose Monitor (RTCGM) Use Associated with Decreased Diabetes Medical Costs for Patients with Type 2 Diabetes (T2D),” was presented at ADA 2021.