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IV analysis accounting for endogeneity of treatment setting indicates hospital-based monitoring is causally linked to higher total annual healthcare costs. The estimated local average treatment effect of hospital-based monitoring on total annual healthcare costs was higher (117.2%, 95% CI 23.3%, 211.1%) than GP-based monitoring. No difference of treatment settings' quality based on evidence of hospitalizations was found. For patients with moderate disease severity T2D, IV analysis accounting for treatment setting endogeneity bias identif