薬経済学: オープンアクセス

The Role of Health Technology Assessment in the Adoption of New Technologies in Diabetes Care: A Review of HTA Reports on Freestyle Libre

Abstract

Fleur Levrat-Guillen, Deirdre Blissett, Rachel Beckerman, Carlos Martín Saborido and Pierre-Yves Benhamou

Aims: This study aimed to identify all Health Technology Assessment (HTA) reports published by HTA bodies assessing FreeStyle Libre and consider how differences in methodologies contribute to variation in decision-making.

Methods: The literature search conducted in October 2018 targeted 158 HTA body websites in 45 countries. Data were extracted and results were analysed under four themes to assess clinical and economic evidence, engagement with stakeholders and conclusions and recommendations.

Results: This analysis included 17 HTA reports. Despite uncertainties in the evidence, a majority concluded FreeStyle Libre reduces the frequency and time in hypoglycaemia and improves patient satisfaction compared to self-monitoring blood glucose (SMBG). Across ten HTAs that considered patient and healthcare professional (HCP) feedback, there was strong support for the adoption of FreeStyle Libre. Of 3 HTA bodies that conducted costeffectiveness, two concluded FreeStyle Libre is cost-effective and one that it was cost-effective amongst patients with high test frequencies. In 5 that conducted budget impact analysis, all concluded FreeStyle Libre is more expensive than SMBG and 3 noted FreeStyle Libre may be cost-saving amongst patients with a high-test frequency. Methodologies varied widely in respect to the approach to quality assessment, the assessment of early evidence and how stakeholder feedback is incorporated.

Conclusion: Different methodologies led to variation in conclusions. Despite this most concluded that compared to SMBG, FreeStyle Libre reduces the frequency and time in hypoglycaemia, and is likely cost-effective or cost saving in certain patient populations. The HTA reports that HCP and patient groups support adoption of FreeStyle Libre.