Evaluating the relationship between daily self-monitoring of blood glucose and healthcare costs

SUMMARY

The objectives of this study were to evaluate the economic impact of self-monitoring of blood glucose (SMBG) in a diabetic Medicaid population.

The study was a retrospective, cross-sectional study in a Utah Medicaid population with a diagnosis of diabetes mellitus between 1 June 2001 and 31 December 2001. The main outcome measures were a change from baseline in total healthcare costs and diabetes-related healthcare costs following the initiation of SMBG as measured by a pharmacy claim for glucose monitoring reagent strips.

A total of 665 insulin users and 885 oral agent (OA) users enrolled in the Utah Medicaid programme and were included in the study. OA users with a claim for glucose monitoring reagent strips were approximately 2 years older and had higher co-morbidity, as measured by the RxRisk score, than controls. Only 7.3% practiced SMBG according to American Diabetes Association guidelines. Insulin users with more than two, or more than three strips per day had 65.1% and 41.5% higher total healthcare costs than non-users, respectively. The only significant cost difference for OA users was high strip use, exhibiting 53.5% higher total healthcare costs compared with those using no strips (p = 0.002).

No short-term economic benefit was realised for daily SMBG. Long-term economic return of strip coverage may take more than 1 year, which would need further investigation.

Key words: :

• diabetes
• self-monitoring of blood glucose
• healthcare costs
• diabetes-related costs
• reagent strips