Utilization rate and cost of test strips for self-monitoring blood glucose in the social security system of Argentina

GAGLIARDINO JJ ET AL.

Melbourne

Congreso; IDF Congress; 2013

IDF

Aim: To estimate the use of test strips for self-monitoring blood glucose (SMBG), and percentage of the total prescription cost in the social security system (SSS) of Argentina. Mehtods: Observational retrospective study using registries from one organization of the SSS (OSPERYH; 681 affiliates, test strip use plus clinical/laboratory data during one year) and from two large entities of our SSS, provided by the Pharmaceutical College of the Province of Buenos Aires (COLFARMA; 8115 anonymized recipes of drugs and test strips prescribed in the period February-April 2012). Statistical analysis was done using t-test, ANOVA, Mann-Whitney U and Kruskall-Wallis tests according to data distribution profile. χ2 test was used for proportions. P-values ≤ 0.05 were considered statistically significant. Results: OSPERYH: strips were provided under an audit system that assesses diabetes education, type of treatment and degree of metabolic control. Monthly overall average use was 24.6±14.5 (mean±SD) and was strongly related to treatment (insulin, 34.5±16.6; oral antidiabetic drugs (OAD), 22.5±12.6). In each group, people with HbA1c < 7% used more test strips than those above such value. COLFARMA: Overall average test strip use was 97.5±70.1. The type of treatment significantly affected test strip use: insulin alone, 111.0±76.3; insulin+OAD, 89.0±62.5; combined OAD, 74.7±47.3; and OAD monotherapy, 66.2±45.0 test strips. Despite this use was almost 4 times higher than in OSPERYH, the treatment-dependent pattern was similar in both groups. Test strips represented, on average, 44 and 66% of the total cost of the prescription in COLFARMA and OSPERHY, respectively, and varied according to treatment (OSPERHY vs. COLFARMA: OAD monotherapy, 66 and 85%; combined OAD, 39 and 62%; insulin, 28 and 53%, respectively). Conclusion: Performance, frequency and cost of SMBG was associated with type of treatment and degree of metabolic control. Diabetes education plus an audit system for test strip provision can rationalize their use, decreasing their cost. No conflict of interest