Cost effectiveness analysis of self-monitoring of blood glucose for patients with type 2 diabetes

Self-monitoring of blood glucose (SMBG) is a crucial component of self-management for patients with type 2 diabetes (T2D), enabling individuals to track their blood glucose levels and promptly identify episodes of hypoglycemia or hyperglycemia. This study assesses the cost-effectiveness of SMBG in T2D patients, evaluating its impact on healthcare costs and quality adjustment life years (QALY).

We conducted a cost-effectiveness analysis (CEA) to compare SMBG with no SMBG in terms of long-term healthcare costs and QALY in T2D patients. We used the UK Prospective Diabetes Study (UKPDS) model with microsimulation to simulate lifetime costs and QALYs. The therapeutic benefits of SMBG were derived from a meta-analysis, while we obtained data on direct costs and QALY associated with diabetes-related complications from existing literature. We performed the analysis from the payer's perspective. The CEA threshold was set equal to the per capita GDP, considered to be US$ 4,503. To account for uncertainty, we conducted bootstrap simulations.

The cost-effectiveness analysis revealed that the incremental cost-effectiveness ratio (ICER) for SMBG, compared to no intervention, was US$3,381.1. The incremental cost and QALY for the SMBG group were $191.5 and 0.056, respectively. In 78% of bootstrap iterations, the ICER fell below the cost-effectiveness threshold, with the highest ICER being 1.5 times the threshold.

Our findings indicate that self-monitoring of blood glucose performed twice weekly is cost-effective in patients with T2D compared with no SMBG.

The online version contains supplementary material available at 10.1007/s40200-026-01884-w.