Table 4.
Cost Calculation Inputs and Results for a Commercial Health Plan.
| Parameter | Calculation | Result |
|---|---|---|
| Number of adult members with T1DM | 10 million × 9.3% × 5% | 46 500 |
| Number of adult members with T1DM and hypoglycemia unawareness | 46 500 × 20% | 9300 |
| Number of annual severe hypoglycemic events without RT-CGM | 9300 × 6 episodes | 55 800 |
| Number of annual severe hypoglycemic events requiring hospitalization without RT-CGM | 55 800 × 14.5% | 8091 |
| Number of annual severe hypoglycemic events with RT-CGM | 55 800 – (55 800 × 32%) | 37 944 |
| Number of annual severe hypoglycemic events requiring hospitalization with RT-CGM | 37 944 × 14.5% | 5502 |
| Annual cost of severe hypoglycemic events requiring hospitalization | ||
| Without RT-CGM | 8091 × $21 000 | $169 911 000 |
| With RT-CGM | 5502 × $21 000 | $115 542 000 |
| Difference in cost | $54 369 000 | |
| Cost of RT-CGM (low estimate) | 9300 × $4500 | $41 850 000 |
| Cost of RT-CGM (high estimate) | 9300 × $4900 | $45 570 000 |
| Net cost savings conferred by RT-CGM (based on lower device cost) | $54 369 000 – $41 850 000 | $12 519 000 |
| Net cost savings conferred by RT-CGM (based on higher device cost) | $54 369 000 – $45 570 000 | $8 799 000 |
| Per patient cost savings conferred by RT-CGM (based on lower device cost) | $12 519 000/9300 | $1346 |
| Per patient cost savings conferred by RT-CGM (based on higher device cost) | $8 799 000/9300 | $946 |