Self-monitoring of blood glucose for patients with diabetes on insulin therapy is considered an essential part of management. However, for most patients with type 2 diabetes not using insulin, frequent monitoring of blood sugar levels using blood glucose test strips (BGTS) has not been found to be clinically beneficial and may lead to decreased quality of life and well-being.
The ODPRN has conducted multiple studies on self-monitoring of blood glucose levels (SMBG) primarily focusing on the impact of BGTS quantity limits on utilization, costs and patient outcomes.
In October 2016, the ODPRN published a study in the Canadian Journal of Diabetes evaluating the impact of Ontario’s BGTS quantity limit policy on utilization patterns and costs. The study population included individuals aged 65 and older who received BGTS through the government funded Ontario Drug Benefit (ODB) program between August 1, 2010, and July 31, 2015.
Following the introduction of the Ontario BGTS quantity limit policy in August 2013, the one-year cost savings among individuals aged 65+ was $23.9 million in the year following the policy. This represented a 22.2% decrease in BGTS use and a 22.5% reduction in associated costs compared with the prior year.
The ODPRN performed a subsequent evaluation, replicating the study among individuals under the age of 65, to have a complete picture of overall cost savings through the ODB program. This analysis found an additional $7.7 million was saved in the year following the implementation of the BGTS quantity limit policy among individuals aged <65. Similar to trends observed in the original study, BGTS utilization and costs among those aged <65 decreased by 22.4% following the policy compared with the year prior.
Overall, the introduction of quantity limits for BGTS in Ontario led to a 22.3% reduction in utilization and 22.4% reduction in associated costs among individuals receiving publically-funded test strips, representing an overall cost savings of $31.6 million in the year following implementation.