Kontakt 2024, 26(2):198-207 | DOI: 10.32725/kont.2024.028

The impact of full reimbursement of flash glucose monitoring on Czech patients - experience of one diabetes centerSocial Sciences in Health - Original article

Kateřina Štechová¹, Radek Kovács^{2, *}, Martina Tuháčková¹, Martina Salátová¹, Šárka Malá¹, Pavlína Piťhová¹, Dita Pichlerová¹

¹ Charles University and Motol University Hospital, 2nd Faculty of Medicine, Department of Internal Medicine, Prague, Czech Republic

² Charles University, Faculty of Social Sciences, Department of Public and Social Policy, Prague, Czech Republic

The introduction of glucose sensors has been a major shift in glycemic self-monitoring. The aim of the study was to analyze the medical effect of Flash Glucose Monitoring (FGM) in type 1 diabetes patients at our clinic, in the context of the introduction of full reimbursement of FGM technology from public health insurance. We studied 64 women and 51 men (median age 42 years). All patients were treated with an intensified insulin regimen. No previous experience with any glucose sensors was reported by 61 patients (43%). Data on diabetes control prior to the introduction of the full FGM reimbursement (2019) and 12 months later (2020) were compared. Additionally, cost-effectiveness analysis was done. Diabetes control improved significantly (p = 0.001 for HbA1c interannual decrease). Results were influenced mainly by the number of applied sensors; surprisingly only 30 patients (29.6%) used all covered sensors. If we consider, for example, a decrease of the risk of the progression of diabetic kidney disease to the end stage of chronic renal failure by 1/3 (due to diabetes control improvement which is achieved by using glucose sensors), there will also be an economic benefit as the cost-effectiveness ratio was calculated for this model situation 6 and the net cost of USD 7,281. The financial barrier is clearly not the only barrier to the widespread use of modern technologies. The results of the study led to the implementation of long-term nudge strategies targeted at both patients and health professionals in our center to improve patients' prognosis.

Keywords: Cost Effectiveness Analysis; Flash Glucose Monitoring; Full Reimbursement; Health Insurance; Type 1 Diabetes Mellitus

Grants and funding:

This study was developed as an output from the Specific Higher Education Research (SVV 260 596) and the Grant Agency of Charles University (project no. 70222).

Conflicts of interest:

The authors have no conflict of interest to declare.

Received: November 2, 2023; Revised: January 29, 2024; Accepted: May 16, 2024; Prepublished online: May 16, 2024; Published: May 31, 2024  Show citation