Cost-effectiveness of continuous glucose monitoring in Chinese adults with uncontrolled type 2 diabetes: A modelling study stratified by baseline HbA1c.

OBJECTIVE: To evaluate the long-term cost-effectiveness of continuous glucose monitoring (CGM) versus self-monitoring of blood glucose (SMBG) in Chinese adults with uncontrolled type 2 diabetes (T2D) to inform optimal disease management and reimbursement policies. METHODS: The United Kingdom Prospective Diabetes Study Outcomes Model version 2 was used to simulate 30-year cost and health outcomes for cohorts with baseline HbA1c levels of 7.70%, 8.70%, 9.70%, and 10.70%. Clinical efficacy data were derived from meta-analyses. A cost-effectiveness analysis from China's healthcare perspective referenced a $40 344 per quality-adjusted life year (QALY) willingness-to-pay (WTP) threshold, equal to three times China's per capita gross domestic product (GDP). Sensitivity and scenario analyses addressed model uncertainty and determined annual CGM cost thresholds. RESULTS: For baseline HbA1c levels of 7.70%-10.70%, CGM yielded incremental cost-effectiveness ratios (ICERs) of $29 428 to $38 819 per QALY gained, respectively-all below the WTP threshold. Higher baseline HbA1c was associated with greater cost-effectiveness. Sensitivity analyses showed CGM utility benefits and device costs were key drivers. All cohorts demonstrated >96% cost-effectiveness probability. Annual CGM cost thresholds for cost-effectiveness ranged from $1920 to $2316 depending on baseline HbA1c levels of 7.70%-10.70%. CONCLUSIONS: CGM represents a cost-effective intervention for Chinese adults with uncontrolled T2D, demonstrating enhanced economic value in populations with elevated baseline HbA1c levels. Implementing risk-stratified reimbursement policies coupled with price negotiations aligned with evidence-based cost thresholds ($1920-$2316 annually), may optimize healthcare resource allocation.