Cost-effectiveness analisys of A1c glycated hemoglobin monitorization with A1CNow in diabetic patients in Brazil

Abstract

Objective: To elaborate a systematic review to evaluate the utility of portable monitors of glycated hemoglobin A1c (A1CNow ) in diabetic and develop cost-effectiveness and budget impact analysis of monitoring A1c with A1CNow in view of the supplementary health system in Brazil. Methods: A search was conducted on the utility of portable monitors of A1c in Medline and Cochrane databases, and the methodological quality of the articles was evaluated by two reviewers. Only clinical trials were included. Cost-effectiveness analysis was carried out, based on Markov model, considering type 2 diabetic patients, comparing A1CNow and laboratory monitoring, the lifetime horizon and perspective of the supplementary health system in Brazil. Budget impact analysis was performed, considering the eligible population and direct costs. Results: Cost-effectiveness analysis has shown that monitoring with A1CNow is dominant to the laboratory monitoring, with better clinical outcomes and lower total cost of treatment. Budget impact found that A1CNow represents an average reduction of $ 54.8 million per year. Conclusions: Considering the willingness to pay, A1CNow is cost-effective in 90.6% of the scenarios. The coverage of A1CNow generates savings for the supplementary health system in Brazil, considering the complications of diabetes preve.