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HEALTH-ECONOMIC ANALYSIS OF THE USE OF SENSOR-AUGMENTED PUMP WITH PREDICTIVE SUSPEND FUNCTION (SAP) THERAPY IN SWEDEN COMPARED TO INSULIN PUMP THERAPY ALONE (CSII), IN TYPE 1 DIABETIC PATIENTS
HEVA HEOR Sarl, Lyon, France.
HEVA HEOR Sarl, Lyon, France.
Medtronic International Sàrl, Tolochenaz, Switzerland.
Örebro University, School of Medical Sciences.ORCID iD: 0000-0003-1025-1682
2016 (English)In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 19, no 7, A699-A699 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: To assess the cost-effectiveness and to project the clinical benefits of sensor augmented pump (SAP) compared to continuous subcutaneous insulin infu-sion therapy (CSII), in Swedish type 1 diabetic patients (T1D).

Methods: The Core Diabetes Model is a simulation model to determine the long-term health economic outcomes of diabetes interventions. It was used to project the incidence of diabetes-related complications over a lifetime horizon, based on a) a meta-analysis compar-ing SAP versus CSII for the uncontrolled T1D population and b) on a randomized trial for the hypo-unaware population. The meta-analysis showed that for the cohort based on the Swedish registry NDR 2014, with a mean HbA1c of 63.14 mmol/mol, age of 46 years and a diabetes duration of 24-years led to a reduction of -0.58% versus -0.14% HbA1c, for SAP and CSII respectively. In the hypo-unaware popula-tion severe hypoglycemic events were observed at 2.2 per 100 patient’s months and 0 for CSII and SAP respectively.

Results: The incremental cost-effectiveness ratio (ICER) was 251’896 SEK per Quality Adjusted Life Year gained (QALY) based on a societal perspective for the uncontrolled population. In the hypo-unaware population the ICER was 139’795 SEK/QALY. The improvement in QALYs were 1.07 and 1.88 years in favor of SAP in the uncontrolled and hypo-unaware population respectively. Additional related costs were partially offset by the savings due to the reduction in complications. Delay of onset of complications were achieved with SAP compared to CSII alone, such as neuropathy (1.04 years), ulcer (0.92 years) and stroke (0.64 years).

Conclusions: These results indicate that accordingly to commonly accepted threshold in Sweden, SAP with predictive suspend function compared to CSII alone can be considered as good value for money in T1D both indications: uncontrolled and hypo-unaware. Extensive sensitivity analysis on key drivers confirmed the robustness of results.

Place, publisher, year, edition, pages
Elsevier, 2016. Vol. 19, no 7, A699-A699 p.
National Category
Endocrinology and Diabetes Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:oru:diva-57524ISI: 000396606302236OAI: oai:DiVA.org:oru-57524DiVA: diva2:1092279
Available from: 2017-05-02 Created: 2017-05-02 Last updated: 2017-10-18Bibliographically approved

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