To Örebro University

Background and Aims: The standard of care for people with type 1 diabetes (T1D) is continually evolving and Automated Insulin Delivery system (AID) systems and continuous glucose monitoring (CGM) are emerging as the standard of care for many individuals with T1D. This study aimed to compare the long-term cost-effec-tiveness of the MiniMedTM 780G system versus MDI+ intermittently scanning CGM in people with T1D across European countries.

Methods: Long-term costs and clinical outcomes were estimated using the CORE Diabetes Model. Clinical data were derived from ADAPT, prospective, multicentre,   open-label, randomized control trial [1]. MiniMedTM 780G system was associated with a reduction in HbA1c of 1.54%, from 9.04% (75 mmol/mol) at baseline to 7.5% (58 mmol/mol) at the end oft he study; isCGM was associated with a reduction in HbA1c of 0.2%1. Quality of life benefits associated with a reduced fear of hypoglycaemia were also applied. Analyses were conducted in Sweden and other countries across Europe.

Results: The MiniMedTM 780G system was associated with aquality-adjusted life-year (QALY) gain of 2.24 with higher overall costs versus MDI+isCGM, leading to an incremental cost-effectiveness ratio of SEK 366,919 (33,757 Euro) per QALY-gained. MiniMedTM 780G system resulted in a lower cumulative incidence of diabetes-related complications. Higher acquisition costs were partially offset by reduced complications costs. Extensive analysis of key drivers and analysis conducted across different countries confirmed the robustness of the results.

Conclusions: Over patient lifetimes, for adults with T1D, the use of the AID system is projected to be cost-effective when compared with MDI+isCGM.

1. Choudhary P, et al. Lancet Diabetes Endocrinol 2022 https://doi.org/10.1016/S2213-8587(22)00212-1.