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Cost-Effectiveness Analysis of the MiniMed 670G Hybrid Closed-Loop System Versus Continuous Subcutaneous Insulin Infusion for Treatment of Type 1 Diabetes
Örebro University, School of Medical Sciences.ORCID iD: 0000-0003-1025-1682
Ossian Health Economics and Communications GmbH, Basel, Switzerland.
Medtronic International Trading Sàrl, Tolochenaz, Switzerland.
Ossian Health Economics and Communications GmbH, Basel, Switzerland.
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2019 (English)In: Diabetes Technology & Therapeutics, ISSN 1520-9156, E-ISSN 1557-8593, Vol. 21, no 3, p. 110-118Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Hybrid closed-loop (HCL) systems combine continuous glucose monitoring with continuous subcutaneous insulin infusion (CSII) to continuously self-adjust basal insulin delivery. Relative to CSII, HCL improves glycemic control and reduces the risk of hypoglycemia but has higher acquisition costs. The aim of this analysis was to assess the cost-effectiveness of the MiniMed™ 670G HCL system versus CSII in people with type 1 diabetes (T1D) in Sweden.

METHODS: Cost-effectiveness analysis, from a societal perspective, was performed over patient lifetimes using the IQVIA CORE Diabetes Model. Clinical data were sourced from a study comparing the MiniMed 670G system with CSII in people with T1D. Cost data, expressed in 2018 Swedish krona (SEK), were obtained from Swedish reference prices and published literature.

RESULTS: The MiniMed 670G system was associated with a quality-adjusted life-year (QALY) gain of 1.90 but higher overall costs versus CSII, leading to an incremental cost-effectiveness ratio (ICER) of SEK 164,236 per QALY gained. Use of the HCL system resulted in a lower cumulative incidence of diabetes-related complications. Higher HCL system acquisition costs were partially offset by reduced complication costs and productivity losses. In people with T1D poorly controlled at baseline, the MiniMed 670G system was associated with 2.25 incremental QALYs versus CSII, yielding an ICER of SEK 15,830 per QALY gained.

CONCLUSIONS: The MiniMed 670G system was associated with clinical benefits and quality-of-life improvements in people with T1D relative to CSII. At a willingness-to-pay threshold of SEK 300,000 per QALY gained, this HCL system likely represents a cost-effective treatment option for people with T1D in Sweden.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2019. Vol. 21, no 3, p. 110-118
Keywords [en]
Cost-effectiveness, Hybrid closed-loop insulin delivery, MiniMed 670G, Sweden, Type 1 diabetes
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-72778DOI: 10.1089/dia.2018.0328ISI: 000463914500003PubMedID: 30785311Scopus ID: 2-s2.0-85062587273OAI: oai:DiVA.org:oru-72778DiVA, id: diva2:1291343
Note

Funding Agency:

Medtronic International Trading Sarl 

Available from: 2019-02-25 Created: 2019-02-25 Last updated: 2019-06-19Bibliographically approved

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Jendle, Johan

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