{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:20:43Z","timestamp":1788459643983,"version":"build-2803163510"},"reference-count":53,"publisher":"Becaris Publishing Limited","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>\n                    <jats:bold>Aim:<\/jats:bold>\n                    Continuous glucose monitoring (CGM) supports glycemic control and reduces diabetes complications. CGM systems include intermittently scanned CGM (is-CGM) and real-time CGM (rt-CGM). While rt-CGM may provide better outcomes than is-CGM, it costs more upfront and its cost-effectiveness in Canada has not been established. We assessed the cost-effectiveness of rt-CGM versus is-CGM in people with insulin-treated Type 2 diabetes mellitus (T2DM) from a Canadian healthcare payer perspective.\n                    <jats:bold>Materials &amp; methods:<\/jats:bold>\n                    We used the ECHO-T2DM microsimulation model to estimate incremental lifetime health outcomes and costs of rt-CGM versus is-CGM. Clinical inputs came from an indirect treatment comparison; cost and utility data were drawn from published sources. Sensitivity analyses tested robustness.\n                    <jats:bold>Results:<\/jats:bold>\n                    Rt-CGM was more effective and less costly than is-CGM, yielding 0.346 additional quality-adjusted life-years and CAD 2237 in savings over 30 years. Benefits stemmed primarily from better glycemic control and fewer complications, reductions in glycemic events, and reduced fear of hypoglycemia. Although rt-CGM incurred CAD 3867 higher acquisition costs, these were more than offset by avoided complications. Deterministic analysis showed dominance in 14 of 18 scenarios, and cost-effectiveness in the remaining four. Uncertainty analysis showed rt-CGM had an ICER below CAD 50,000 in 98% of simulations.\n                    <jats:bold>Discussion:<\/jats:bold>\n                    Rt-CGM is potentially a cost-saving alternative to is-CGM among people with insulin-treated T2DM in Canada. This finding was strengthened by rigorous sensitivity analysis. Study strengths include use of a validated microsimulation model and adoption of conservative assumptions. Limitations include absence of head-to-head trial evidence and indirect use of time in and out of range.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Rt-CGM is a potentially cost-saving option for managing insulin-treated T2DM in Canada, with implications for clinical practice and reimbursement policy.\n                  <\/jats:p>","DOI":"10.57264\/cer-2025-0125","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T09:35:27Z","timestamp":1758706527000},"source":"Crossref","is-referenced-by-count":4,"title":["The cost-effectiveness of real-time continuous glucose monitoring versus intermittently scanned continuous glucose monitoring in individuals with insulin-treated Type 2 diabetes mellitus in Canada"],"prefix":"10.57264","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6565-7025","authenticated-orcid":false,"given":"Michael","family":"Willis","sequence":"first","affiliation":[{"name":"The Swedish Institute for Health Economics, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4604-7766","authenticated-orcid":false,"given":"Andreas","family":"Nilsson","sequence":"additional","affiliation":[{"name":"The Swedish Institute for Health Economics, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3952-1113","authenticated-orcid":false,"given":"Hamza","family":"Alshannaq","sequence":"additional","affiliation":[{"name":"Dexcom Inc, San Diego, CA 92121, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7956-1606","authenticated-orcid":false,"given":"Jessica","family":"Matuoka","sequence":"additional","affiliation":[{"name":"Dexcom Inc, San Diego, CA 92121, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7989-9597","authenticated-orcid":false,"given":"Gregory","family":"Norman","sequence":"additional","affiliation":[{"name":"Dexcom Inc, San Diego, CA 92121, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"36897","reference":[{"key":"e_1_3_9_3_2","unstructured":"Diabetes Canada. 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