Opportunity and cost: Self-monitoring of blood glucose in Manitoba, 2000-2013
Canadian Pharmacists Conference ePoster Library. Bugden S. Jun 25, 2016; 132144
Disclosure(s): Nothing to disclose.
Dr. Shawn Bugden
Dr. Shawn Bugden
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Abstract
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OBJECTIVES: Given the limited evidence of benefit of frequent self-monitoring of blood glucose (SMBG) by non-insulin using patients with diabetes, new guidelines and test strip limit policies have been suggested and implemented in various Canadian jurisdictions. The objective of this study was to assess the overall utilization and cost associated with blood glucose test strips (BGTS) and lancets for SMBG in Manitoba from 2000 to 2013 and to assess potential implications of such a policy.,METHODS: A cohort of all patients with diabetes in Manitoba from 2000-2013 was established. Test strip and lancet utilization and cost were assessed for the overall cohort and for subgroups based on the type of diabetes treatment. The potential opportunity for a more selective practice of SMBG was assessed.,RESULTS: In the year 2000, 8 million BGTS were dispensed in Manitoba, and this increased by 270% to 21.7 million by 2013. Insulin users accounted for the majority of test strip use. However, it was estimated that test strip use could be reduced by 16 million test strips over 5 years by taking a guideline based approach to monitoring, with 95% of the potential reduction occurring in groups not using insulin. Over the next 5 years, a guideline based approach is projected to save $12.35 million, including $7.3 million in government spending.,CONCLUSIONS: Some provinces have placed therapy-linked limits on BGTS use. Whether or not a test strip limit policy is in place there is an important opportunity for pharmacists to help guide patients with diabetes to determine optimal frequency of SMBG. Expenditures above guideline recommendations represent an opportunity cost, money which could be redirected to programs and more useful interventions for the growing population of patients with diabetes in Manitoba.
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