Cost-Effectiveness Analysis of an Advanced Hybrid Closed Loop System Versus Standard of Care in the Management of Type 1 Diabetes in the Netherlands

Speaker(s)

Serné EH1, Buompensiere MI2, Ozdemir Saltik AZ3, Yu J3, de Portu S2, Cohen O2
1University of Amsterdam, Amsterdam, Netherlands, 2Medtronic International Trading Sàrl, Tolochenaz, Switzerland, 3Medtronic International Trading Sàrl, Tolochenaz, VD, Switzerland

Presentation Documents

OBJECTIVES: An advanced hybrid closed loop (AHCL) system, with automated basal and bolus correction insulin delivery, was found to be cost-effective in various European markets including the Netherlands, based on trials with baseline HbA1c >8%.[1] This study aimed to assess the cost-effectiveness of AHCL versus standard of care (SoC, multiple daily injections or pump with intermittently-scanned or continuous glucose monitoring) in those with baseline HbA1c <8% (64 mmol/mol), still not reaching glycaemic targets in the Netherlands, to address the health economics of AHCL for the full range of baseline HbA1c levels.

METHODS: Effectiveness data were derived from a prospective, multicentre study[2], which demonstrated 0.56% reduction in HbA1c with AHCL, from 7.43% (57 mmol/mol) at baseline to 6.88% (52 mmol/mol) after 3 months. Costs and clinical outcomes were estimated using the IQVIA CORE Diabetes Model. A Dutch payer perspective was adopted over a lifetime for a cohort aged 39.9 years. A willingness-to-pay threshold of €80.000 was used, an annual discount rate of 3% applied.

RESULTS: AHCL was projected to provide 0.66 quality-adjusted life years (QALYs) gained, corresponding to 240 days more in full health versus SoC. Total costs were €25,345 higher, with AHCL resulting in an ICER of €38,536/QALY-gained. AHCL led to lower cumulative incidence of diabetes-related complications. Higher acquisition costs were partially offset by reduced complications costs. Sensitivity analyses showed that the results were robust to changes in baseline HbA1c but sensitive to treatment effects.

CONCLUSIONS: Over a lifetime, AHCL proved to be cost-effective, albeit more costly compared with SoC in persons with HbA1c of 7.43% (57 mmol/mol) not reaching glycaemic targets in the Netherlands. This finding underscores the potential of AHCL in improving T1D management, and its cost-effectiveness through the full range of HbA1c.

[1] Jendle J, et al. Diabetes Technol Ther. 2023;25(12):864-876.

[2] Beato-Vibora PI, et al. Diabetes Care. 2024;47:216–224.

Code

EE783

Topic

Economic Evaluation, Medical Technologies, Methodological & Statistical Research, Study Approaches

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis, Decision Modeling & Simulation, Medical Devices

Disease

Diabetes/Endocrine/Metabolic Disorders (including obesity), Medical Devices