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The Cost-Effectiveness of an Advanced Hybrid Closed-Loop System in People with Type 1 Diabetes: a Health Economic Analysis in Sweden
Örebro University, School of Medical Sciences.ORCID iD: 0000-0003-1025-1682
Medtronic International Trading Sàrl, Tolochenaz, Switzerland.
Medtronic Denmark, Copenhagen, Denmark.
Medtronic International Trading Sàrl, Tolochenaz, Switzerland.
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2021 (English)In: Diabetes Therapy, ISSN 1869-6953, E-ISSN 1869-6961, Vol. 12, no 11, p. 2977-2991Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Swedish National Diabetes Registry data show a correlation of improved glycemic control in people with type 1 diabetes (T1D) with increased use of diabetes technologies over the past 25 years. However, novel technologies are often associated with a high initial outlay. The aim of the present study was to evaluate the long-term cost-effectiveness of the advanced hybrid closed-loop (AHCL) MiniMed 780G system versus intermittently scanned continuous glucose monitoring (isCGM) plus self-injection of multiple daily insulin (MDI) or continuous subcutaneous insulin infusion (CSII) in people with T1D in Sweden.

METHODS: Outcomes were projected over patients' lifetimes using the IQVIA CORE Diabetes Model (v9.0). Clinical data, including changes in glycated hemoglobin (HbA1c) and hypoglycemia rates, were sourced from observational studies and a randomized crossover trial. Modeled patients were assumed to receive the treatments for their lifetimes, with HbA1c kept constant following the application of treatment effects. Costs were accounted from a societal perspective and expressed in Swedish krona (SEK). Utilities and days off work estimates were taken from published sources.

RESULTS: The MiniMed 780G system was associated with an improvement in life expectancy of 0.16 years and an improvement in quality-adjusted life expectancy of 1.95 quality-adjusted life years (QALYs) versus isCGM plus MDI or CSII. These clinical benefits were due to a reduced incidence and a delayed time to onset of diabetes-related complications. Combined costs were estimated to be SEK 727,408 (EUR 72,741) higher with MiniMed 780G, with treatment costs partially offset by direct cost savings from the avoidance of diabetes-related complications and indirect cost savings from the avoidance of lost workplace productivity. The MiniMed 780G system was associated with an incremental cost-effectiveness ratio of SEK 373,700 per QALY gained.

CONCLUSIONS: Based on a willingness-to-pay threshold of SEK 500,000 per QALY gained, the MiniMed 780G system was projected to be cost-effective versus isCGM plus MDI or CSII for the treatment of T1D in Sweden.

Place, publisher, year, edition, pages
Springer, 2021. Vol. 12, no 11, p. 2977-2991
Keywords [en]
Advanced hybrid closed-loop, Cost-effectiveness, Sweden, Type 1 diabetes
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-94785DOI: 10.1007/s13300-021-01157-0ISI: 000702605000003PubMedID: 34596879Scopus ID: 2-s2.0-85116160285OAI: oai:DiVA.org:oru-94785DiVA, id: diva2:1600036
Note

Funding agency:

Medtronic International Trading Sàrl, Geneva, Switzerland

Available from: 2021-10-04 Created: 2021-10-04 Last updated: 2021-12-01Bibliographically approved

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Jendle, Johan

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