Cost-effectiveness of sensor-augmented pump therapy versus standard insulin pump therapy in patients with type 1 diabetes in Denmark
| Autor: | S Roze, Jayne Smith-Palmer, Martin Ridderstråle, S De Portu, Alexis Delbaere, William J. Valentine |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Insulin pump Pediatrics medicine.medical_specialty Adolescent Cost effectiveness Cost-Benefit Analysis Denmark Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Hypoglycemia 03 medical and health sciences Insulin Infusion Systems 0302 clinical medicine Endocrinology Diabetes model Diabetes mellitus Internal Medicine Humans Hypoglycemic Agents Insulin Medicine In patient 030212 general & internal medicine Low glucose suspend health care economics and organizations Type 1 diabetes business.industry Blood Glucose Self-Monitoring General Medicine medicine.disease Surgery Diabetes Mellitus Type 1 Hyperglycemia Quality of Life business |
| Zdroj: | Diabetes Research and Clinical Practice. 128:6-14 |
| ISSN: | 0168-8227 |
| DOI: | 10.1016/j.diabres.2017.02.009 |
| Popis: | Aims The use of continuous subcutaneous insulin infusion (CSII) in type 1 diabetes (T1D) has increased in recent years. Sensor-augmented pump therapy (SAP) with low glucose suspend (LGS) (allowing temporary suspension of insulin delivery if blood glucose level falls below a pre-defined threshold level) provides additional benefits over CSII alone, but is associated with higher acquisition costs. Therefore, a cost-effectiveness analysis of SAP + LGS versus CSII in patients with T1D was performed. Methods Analyses were performed using the CORE Diabetes Model in two different patient cohorts in Denmark, one with hyperglycemia at baseline and one with increased risk for hypoglycemic events. Clinical input data were sourced from published literature. The analysis was performed over a lifetime time horizon from a societal perspective. Future costs and clinical outcomes were discounted at 3% per annum. Results In patients who were hyperglycemic at baseline the use of SAP + LGS versus CSII resulted in improved quality-adjusted life expectancy (12.44 versus 10.99 quality-adjusted life years [QALYs]) but higher mean lifetime costs (DKK 2,027,316 versus DKK 1,801,293) leading to an incremental cost-effectiveness ratio (ICER) of DKK 156,082 per QALY gained. For patients at increased risk for hypoglycemic events the ICER for SAP + LGS versus CSII was DKK 89,868 per QALY gained. Conclusions The ICER for SAP + LGS versus CSII falls below commonly cited willingness-to-pay thresholds. Therefore, in Denmark, the use of SAP + LGS is likely to be considered cost-effective relative to CSII for patients with T1D who are either hyperglycemic, despite CSII use, or who experience frequent severe hypoglycemic events. |
| Databáze: | OpenAIRE |
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