Cost Comparison for Glucose Testing by Point-of-Care Glucose Meter Compared With a Standard Laboratory Clinical Chemistry Analyzer: A Patient's Perspective From the Country of Thailand

摘要

Monitoring of blood glucose levels is standard of care for the management of diabetes mellitus. To determine glucose levels, various clinical chemistry techniques can be used. Patient self-monitoring using handheld capillary blood glucose monitors is commonly practiced throughout the world and has permitted improved outcomes for diabetic patients by facilitating achievement of tight glycemic control. However, these devices and the reagent strips can be expensive particularly for poor patients without medical insurance. In less well-developed countries with large populations of people in poverty, the cost issues are especially significant. Furthermore, cost issues may significantly limit the frequency of testing compared with what might be considered optimal for diabetic management. Here, the author performs a cost analysis study to compare the determination of glucose by point-of-care glucose meter versus a laboratory clinical chemistry analyzer from the perspective of the patient. According to this study, for a patient in Thailand, the cost per test for the glucose meter is more expensive than the laboratory test if the number of tests performed is less than 78 tests. If the patient purchases the point-of-care meter, it will take about 6.5 years of use to reach the break-even point (if the blood glucose testing is recommended as a monthly follow-up). Therefore, the point-of-care meter is not a good alternative for short-term use, based on medical economics existing in Thailand. Glucose monitoring using a point-of-care device can be economically justified for both long-term monthly follow-up and for frequent home monitoring of diabetic patients.