Promoting health and reducing costs: a role for reform of self-monitoring of blood glucose provision within the National Health Service.
Diabet Med
; 33(5): 681-90, 2016 May.
Article
de En
| MEDLINE
| ID: mdl-26443548
ABSTRACT
AIM:
To determine the cost-effectiveness of all options for the self-monitoring of blood glucose funded by the National Health Service, providing guidance for disinvestment and testing the hypothesis that advanced meter features may justify higher prices.METHODS:
Using data from the Health and Social Care Information Centre concerning all 8 340 700 self-monitoring of blood glucose-related prescriptions during 2013/2014, we conducted a cost-minimization analysis, considering both strip and lancet costs, including all clinically equivalent technologies for self-monitoring of blood glucose, as determined by the ability to meet ISO-151972013 guidelines for meter accuracy.RESULTS:
A total of 56 glucose monitor, test strip and lancet combinations were identified, of which 38 met the required accuracy standards. Of these, the mean (range) net ingredient costs for test strips and lancets were £0.27 (£0.14-£0.32) and £0.04 (£0.02-£0.05), respectively, resulting in a weighted average of £0.28 (£0.18-£0.37) per test. Systems providing four or more advanced features were priced equal to those providing just one feature. A total of £12 m was invested in providing 42 million self-monitoring of blood glucose tests with systems that fail to meet acceptable accuracy standards, and efficiency savings of £23.2 m per annum are achievable if the National Health Service were to disinvest from technologies providing lesser functionality than available alternatives, but at a much higher price.CONCLUSION:
The study uncovered considerable variation in the price paid by the National Health Service for self-monitoring of blood glucose, which could not be explained by the availability of advanced meter features. A standardized approach to self-monitoring of blood glucose prescribing could achieve significant efficiency savings for the National Health Service, whilst increasing overall utilisation and improving safety for those currently using systems that fail to meet acceptable standards for measurement accuracy.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Autosurveillance glycémique
/
Coûts des soins de santé
/
Économies
/
Réforme des soins de santé
/
Modèles économiques
/
Diabète
/
Promotion de la santé
Type d'étude:
Diagnostic_studies
/
Guideline
/
Health_economic_evaluation
/
Prognostic_studies
Limites:
Humans
Pays/Région comme sujet:
Europa
Langue:
En
Journal:
Diabet Med
Sujet du journal:
ENDOCRINOLOGIA
Année:
2016
Type de document:
Article
Pays d'affiliation:
Royaume-Uni