Point-of-Care Hemoglobin A1c Testing: A Budget Impact Analysis

Area of Science:

• Clinical Chemistry
• Health Economics
• Diabetes Management

Background:

• Rising diabetes prevalence necessitates increased hemoglobin A1c (HbA1c) testing for glycemic control.
• Point-of-care HbA1c testing may enhance system efficiency if results align with laboratory measurements.

Purpose of the Study:

• To estimate the budget impact of utilizing point-of-care HbA1c testing instead of laboratory-based testing for diabetes monitoring in 2013/2014.

Main Methods:

• Compared costs of three Health Canada-licensed point-of-care HbA1c devices (A1cNow+, DCA Vantage, In2it) against the laboratory reference method.
• Calculated cost differences and estimated net impact through sensitivity analyses.

Main Results:

• Total annual costs for laboratory and point-of-care HbA1c testing were $91.5 million and $86.8 million, respectively, in 2013/2014.
• Replacing all laboratory HbA1c measurements with point-of-care testing could yield savings of approximately $4.7 million annually.
• Excluding physician fees from the analysis indicated a potential net impact on the healthcare system.

Conclusions:

• Point-of-care HbA1c technology is utilized in Ontario, but its adoption rate is unclear.
• Replacing or combining point-of-care HbA1c testing with laboratory methods could have saved Ontario between $1,175,620 and $4,702,481 in 2013/2014.
• Determining the market share of point-of-care HbA1c technology is crucial for precise budget impact assessments.