Cost-Effectiveness Analysis of the MiniMed 670G Hybrid Closed-Loop System Versus Continuous Subcutaneous Insulin Infusion for Treatment of Type 1 Diabetes

Jendle, Johan; Pöhlmann, Johannes; Portu, Simona de; Smith-Palmer, Jayne; Roze, S

doi:10.1089/dia.2018.0328

Cited by 39 publications

(31 citation statements)

References 56 publications

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“…Integrated CSII and CGM systems were reported as not cost-effective in the only comparison to non-integrated systems [17]. Use of a hybrid closed loop system was considered cost-effective when compared to CSII and SMBG in the Swedish context with an adjusted ICER of $25,327 AUD ($17,817 USD) per QALY gained [38].…”

Section: Resultsmentioning

confidence: 99%

“…Treatment effects for a hybrid closed loop system were based on a pivotal trial and before-and-after study without comparator arms [ 49 , 50 ]. The hybrid closed loop system was modelled to reduce HbA1c by 0.5% (5.5 mmol/mol) [ 49 ] and was assumed to prevent all episodes of severe hypoglycaemia over a lifetime [ 38 ]. For economic evaluation, the comparator of CSII and SMBG was assumed to have no impact on HbA1c, and severe hypoglycaemia was modelled to occur at a rate of 25 events per 100 person-years requiring medical assistance and 65 events per 100 person-years requiring non-medical assistance [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

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Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis

et al. 2020

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Background: With the rapid development of technologies for type 1 diabetes, economic evaluations are integral in guiding cost-effective clinical and policy decisions. We therefore aimed to review and synthesise the current economic literature for available diabetes management technologies and outline key determinants of costeffectiveness. Methods: A systematic search was conducted in April 2019 that focused on modelling or trial based economic evaluations. Searched databases included Medline, Medline in-process and other non-indexed citations, EMBASE, PubMed, All Evidenced Based Medicine Reviews, EconLit, Cost-effectiveness analysis Registry, Research Papers in Economics, Web of Science, PsycInfo, CINAHL, and PROSPERO from inception. We assessed quality of included studies with the Questionnaire to Assess Relevance and Credibility of Modeling Studies for Informing Health Care Decision Making an ISPOR-AMCP-NPC good practice task force report. Screening of abstracts and full-texts, appraisal, and extraction were performed by two independent researches. Results: We identified 16,772 publications, of which 35 were analysed and included 11 health technologies. Despite a lack of consensus, most studies reported that insulin pumps (56%) or interstitial glucose sensors (62%) were costeffective, although incremental cost-effectiveness ratios ranged widely ($14,266-$2,997,832 USD). Cost-effectiveness for combined insulin pumps and glucose sensors was less clear. Determinants of cost-effectiveness included treatment effects on glycosylated haemoglobin and hypoglycaemia, costing of technologies and complications, and measures of utility. Conclusions: Insulin pumps or glucose sensors appeared cost-effective, particularly in populations with higher HbA1c levels and rates of hypoglycaemia. However, cost-effectiveness for combined insulin pumps and glucose sensors was less clear. Registration: The study was registered with PROSPERO, number CRD42017077221.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis

et al. 2020

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“…According to systematic reviews, potential benefits of SCI include improved glycaemic control, reduction in the hypoglycaemia unawareness, lower insulin doses, high absorption, and a lower frequency of severe hypoglycaemia [59][60][61]. Due to the development of sensor augmented insulin therapy with or without suspend functions [62,63], the T1DM control and quality of life for patients have significantly enhanced [64,65]. Moreover, SCI is most successful in individuals motivated to manage their condition and supported by a multidisciplinary team with expertise in the delivery of SCI [66].…”

Section: Subcutaneous Versus Inhaled Insulinmentioning

confidence: 99%

Artificial Pancreas Control Strategies Used for Type 1 Diabetes Control and Treatment: A Comprehensive Analysis

Mehmood

Ahmad

Arif

et al. 2020

ASI

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This paper presents a comprehensive survey about the fundamental components of the artificial pancreas (AP) system including insulin administration and delivery, glucose measurement (GM), and control strategies/algorithms used for type 1 diabetes mellitus (T1DM) treatment and control. Our main focus is on the T1DM that emerges due to pancreas’s failure to produce sufficient insulin due to the loss of beta cells (β-cells). We discuss various insulin administration and delivery methods including physiological methods, open-loop, and closed-loop schemes. Furthermore, we report several factors such as hyperglycemia, hypoglycemia, and many other physical factors that need to be considered while infusing insulin in human body via AP systems. We discuss three prominent control algorithms including proportional-integral- derivative (PID), fuzzy logic, and model predictive, which have been clinically evaluated and have all shown promising results. In addition, linear and non-linear insulin infusion control schemes have been formally discussed. To the best of our knowledge, this is the first work which systematically covers recent developments in the AP components with a solid foundation for future studies in the T1DM field.

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“…The second two articles explore the cost-effectiveness of SAP and HCL, both CGM sensor-dependent technologies (9,10). Cost-effectiveness is by nature a relative measure, both influenced by the comparator category and by how investigators predict future morbidity and mortality.…”

Section: Commentmentioning

confidence: 99%

Practical Implementation of Diabetes Technology: Real‐World Use

Messer

Weinzimer

2020

Diabetes Technology & Therapeutics

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IntroductionT he purpose of the practical implementation article of the ATTD Yearbook is to characterize the current diabetes technology landscape around the globe, focusing on emerging trends in device uptake, clinical utility and guidance, access to devices, educational strategies, and perceived benefit and burden of device use (1). Articles selected for this review were published between July 2018 and June 2019 and contained original research related to diabetes technology use in the real world rather than a structured research setting. Keyword searches included ''education, access, economics, cost effectiveness, real world, behavior, barriers, registry, outcomes, implementation, decision support, and technology.'' A total of 42 articles were retrieved, and 10 were selected for review here.This year's article starts with highlighting new data from the Type 1 Diabetes (T1D) Exchange Registry from 2016 to 2018, which provides relevant insight into diabetes technology trends in the United States (2). As highlighted below, technology uptake has rapidly expanded in the past decade. This is most notable in use of continuous glucose monitoring (CGM), with a five-fold increase in reported use compared with 8 years prior, and a 10-fold increase in use for children <12 years old. Insulin pump use has slightly increased as well. Technophiles can celebrate this trend.The second major point is more sobering: despite this increase in diabetes technology utilization, glycemic control has not improved overall. Glycemic data mirror the data from 8 years prior, with an actual worsening of glycemic control in adolescents. This paradox suggests a more nuanced picture of technology effectiveness, a picture that must include individual factors, clinical factors, and system factors all contributing to the ''real-world'' glycemic benefits of technology.This year's article therefore focuses on extra-technological factors that support or hinder efforts of individuals using diabetes technology to manage diabetes. First, access, insurance coverage, and cost-effectiveness data on sensor augmented pump (SAP) and hybrid closed loop (HCL) are reviewed. Next, new data from educational randomized control trials (RCT) are presented to emphasize the essential place for education in all diabetes self-management. Finally, two studies of automated decision support are reviewed in order to illustrate some of the potential benefits and challenges of bringing this technology to the clinical environment.

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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

Cited by 39 publications

References 56 publications

Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis

Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis

Artificial Pancreas Control Strategies Used for Type 1 Diabetes Control and Treatment: A Comprehensive Analysis

Practical Implementation of Diabetes Technology: Real‐World Use

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