Researchers at the Institute for Clinical Evaluative Sciences (ICES) and St. Michael’s Hospital project the total cost of test strips for older Ontarians will exceed $500 million dollars between 2009 and 2013. According to the researchers, blood glucose test strips were the third largest cost for the Ontario Public Drug Programs in 2007/08, accounting for $100 million or 3.3 per cent of drug expenditures.
“Routine use of blood glucose test strips may not actually improve outcomes and quality of life among most adults with type 2 diabetes treated by oral hypoglycemic agents,” says Tara Gomes, principal investigator and ICES epidemiologist.
The study examined utilization patterns and associated costs of blood glucose test strips by Ontarians aged 65 and older with diabetes between 1997 and 2008 and found:
- More than 117 million test strips were dispensed in Ontario in 2008.
- An increase of nearly 250 per cent in blood glucose test strips used.
- More than 50 per cent of older patients with diabetes received a prescription for blood glucose test strips in 2008 at a total cost of $85.5 million.
- Almost half of the individuals prescribed test strips were at relatively low risk for drug-induced hypoglycemia and may not benefit from routine monitoring, yet accounted for nearly one-third of costs associated with blood glucose test strips in this population.
- This study estimated the total cost of test strips for older Ontarians is projected to exceed half a billion dollars between 2009 and 2013.
- Potential policy scenarios demonstrated that it was possible to make test strip use more efficient, with the potential to reduce utilization by between 9.5 and 74.5 million blood glucose test strips in 2008. This could reduce overall costs by at least $26 million, and as much as $302 million over a 5-year study period.
- Even modest changes in self-monitoring of blood glucose among selected patients with type 2 diabetes could lead to substantial reductions in test strip utilization and costs, allowing the redirection of resources to more effective interventions for patients with diabetes.
“In light of the overall costs and questionable benefits of blood glucose self-monitoring in many patients, more focused policy decisions regarding test strips have been proposed in several jurisdictions,” says Muhammad Mamdani, a co-author and director of the Applied Health Research Centre at St. Michael’s Hospital.
The study “Blood glucose test strips: from evidence to policy” is in the December 21, 2009 issue of CMAJ, and the ICES Investigative Report “Blood Glucose Test Strip Use: Patterns, Costs and Potential Cost Reduction Associated with Reduced Testing” is available online at www.ices.on.ca on the same date.
FOR FURTHER INFORMATION, PLEASE CONTACT:
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