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

Abstract

SUMMARYThe 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.