Cost-effectiveness of sensor-augmented pump therapy in two different patient populations with type 1 diabetes in Italy

Autor: D. D’Ostilio, Antonio Nicolucci, S Roze, M.C. Rossi, Alexis Delbaere, S. de Portu
Rok vydání: 2017
Předmět:
Blood Glucose
Male
Time Factors
Cost effectiveness
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Cost-Benefit Analysis
Medicine (miscellaneous)
Infusions
Subcutaneous
0302 clinical medicine
Risk Factors
Insulin
030212 general & internal medicine
Child
health care economics and organizations
Nutrition and Dietetics
Poor glycemic control
Equipment Design
Treatment Outcome
Italy
Female
Quality-Adjusted Life Years
Cardiology and Cardiovascular Medicine
Incremental cost-effectiveness ratio
Adult
medicine.medical_specialty
Adolescent
Transducers
030209 endocrinology & metabolism
Hypoglycemia
Drug Costs
03 medical and health sciences
Young Adult
Diabetes model
Insulin Infusion Systems
Predictive Value of Tests
medicine
Humans
Hypoglycemic Agents
In patient
Glycated Hemoglobin
Type 1 diabetes
business.industry
Blood Glucose Self-Monitoring
medicine.disease
Diabetes Mellitus
Type 1
Emergency medicine
Quality of Life
business
Biomarkers
Zdroj: Nutrition, metabolism, and cardiovascular diseases : NMCD. 28(7)
ISSN: 1590-3729
Popis: Background and aims Sensor-augmented pump therapy (SAP) combines real time continuous glucose monitoring (CGM) with Continuous Subcutaneous Insulin Infusion (CSII) and provides additional benefits beyond those provided by CSII alone. SAP with automated insulin suspension provides early warning of the onset of hyperglycemia and hypoglycemia and has the functionality to suspend insulin delivery if sensor glucose levels are predicted to fall below a predefined threshold. Aim of this study was to assess the cost-effectiveness of SAP with automated insulin suspension versus CSII alone in type 1 diabetes. Methods and results Cost-effectiveness analysis was performed using the CORE Diabetes Model. The analysis was performed in two different cohorts: one with high baseline HbA1c and one at elevated risk for hypoglycemic events. Clinical input data were sourced from published data. The analysis was conducted from a societal perspective over a lifetime time horizon; costs and clinical outcomes were discounted at 3% per year. In patients with poor glycemic control, SAP with automated insulin suspension resulted in improved discounted quality-adjusted life expectancy (QALY) versus CSII (12.44 QALYs vs. 10.99 QALYs) but higher mean total lifetime costs (€324,991 vs. €259,852), resulting in an incremental cost effectiveness ratio (ICER) of €44,982 per QALY gained. In patients at elevated risk for hypoglycemia, the ICER was €33,692 per QALY gained for SAP versus CSII. Conclusion In Italy, the use of SAP with automated insulin suspension is associated with projected improvements in outcomes as compared to CSII. These benefits translate into an ICER usually considered as good value for money, particularly in patients at elevated risk of hypoglycemia.
Databáze: OpenAIRE
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