Cost-effectiveness of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin

Chris Cameron; Doug Coyle; Ehud Ur; Scott Klarenbach

doi:10.1503/cmaj.090765

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Author's response to Sarraf
Chris Cameron

Posted on: 21 January 2010
Missing the boat
Elie Sarraf

Posted on: 14 January 2010

Posted on: (21 January 2010)
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Author's response to Sarraf
Chris Cameron
The CADTH findings underline the importance of understanding the cost effectiveness of blood glucose test strips to the sustainability of contemporary diabetes care. The number of Canadians diagnosed with diabetes almost doubled, to close to 2.3 million, in the past decade, and another 200,000 people learn they have the disease each year. The technology with respect to self-monitoring of blood glucose has basically been...
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The CADTH findings underline the importance of understanding the cost effectiveness of blood glucose test strips to the sustainability of contemporary diabetes care. The number of Canadians diagnosed with diabetes almost doubled, to close to 2.3 million, in the past decade, and another 200,000 people learn they have the disease each year. The technology with respect to self-monitoring of blood glucose has basically been static for two decades – and is not likely to be replaced in the near future, making effective use of this technology crucial to appropriate allocation of resources.
Further information, reports and supporting tools may be found at: www.cadth.ca/smbg.
Conflict of Interest:
None declared
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Competing Interests: None declared.
Posted on: (14 January 2010)
Page navigation anchor for Missing the boat
Missing the boat
Elie Sarraf, Montreal, QC
I must disagree with the conclusion drawn in this article. Technology is not static, and can never be assumed to be final. One should not focus on a such a variable as the cost of a blood glucose (BG) strip, as it is a technology that will eventually become obsolete. Given the right market conditions, one should expect to see a change; in this case, between having a reusable strip, an implantable BG measuring device, or si...
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I must disagree with the conclusion drawn in this article. Technology is not static, and can never be assumed to be final. One should not focus on a such a variable as the cost of a blood glucose (BG) strip, as it is a technology that will eventually become obsolete. Given the right market conditions, one should expect to see a change; in this case, between having a reusable strip, an implantable BG measuring device, or simply a device that measures BG without breaking the skin (similar to a blood oxygen saturation monitor), the cost of measuring BG will decrease, thus changing the outcomes in your study. Therefore, to suggest simply that it is not cost effective to measure BG daily unless the cost of strips decreases implies a fixation on the present while sacrificing good diabetic control. Rather, one should actively encourage a change in the status quo and even propose an enticement to create a cheaper alternative device.
Conflict of Interest:
None declared
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Competing Interests: None declared.