A Cost-Effectiveness Analysis of Continuous Subcutaneous Insulin Injection versus Multiple Daily Injections in Type 1 Diabetes Patients: A Third-Party US Payer Perspective

Charles, Meaghan St; Lynch, Peter; Graham, Claudia; Minshall, Michael E.

doi:10.1111/j.1524-4733.2008.00478.x

Cited by 40 publications

(38 citation statements)

References 32 publications

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“…The relatively high cost of CSII is another prevalent concern, [29][30][31] especially among those uninsured patients who have economic difficulties. Although the cost directly associated with glucose control was not obtainable from the medical records, it should be certainly higher in the CSII group because of the cost of insulin pump devices, the increased nursing and physician time, and the increased number of daily glucose measurements.…”

Section: Discussionmentioning

confidence: 99%

Short-Term Effects of Continuous Subcutaneous Insulin Infusion Therapy in Perioperative Patients with Diabetes Mellitus

Cai

et al. 2013

Diabetes Technology & Therapeutics

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Background: Hyperglycemia is common and hard to control in surgical patients with diabetes. We retrospectively investigated short-term effects of continuous subcutaneous insulin infusion (CSII) in perioperative patients with diabetes. Patients and Methods: Perioperative patients with diabetes discharged between January 1, 2006 and January 1, 2012 were included. Glucose control and postoperative outcomes were compared between the patients using CSII or non-CSII insulin therapy. Results: We identified 108 pairs of patients matched by propensity and surgical category who were using CSII therapy (CSII group) or non-CSII insulin therapy (control group). The CSII group had significantly lower fasting glucose levels (on the first postoperative day, 9.06 -3.09 mmol/L vs. 11.05 -4.19 mmol/L; P = 0.003) and lower mean glucose levels (on the operation day, 9.93 -2.65 mmol/L vs. 12.05 -3.86 mmol/L; P = 0.001). The CSII group also had a lower incidence of fever (on the first postoperative day, 30.4% vs. 53.2%; P = 0.005). Furthermore, patients in the CSII group experienced significantly shorter postoperative intervals for suture removal (P = 0.02) and hospital discharge (P = 0.03). No significant difference in the total medical expenditure was observed between the two groups (P = 0.47). We also made a comparison between the 30 pairs of patients who were using CSII or multiple daily insulin injection therapy but observed no significant difference between these two therapies in glucose control or postoperative outcomes. Conclusions: Compared with non-CSII insulin therapy, even short-term implementation of CSII can improve the postoperative control of glucose, reduce the incidence of postoperative fever, and shorten the time for suture removal and discharge in surgical patients with diabetes.

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Section: Discussionmentioning

confidence: 99%

Short-Term Effects of Continuous Subcutaneous Insulin Infusion Therapy in Perioperative Patients with Diabetes Mellitus

Cai

et al. 2013

Diabetes Technology & Therapeutics

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“…We applied a 60-year time horizon, consistent with previous studies [12,[15][16][17][18]. This time horizon allows for development of all relevant complications during the remainder of a patient's lifetime.…”

Section: Time Horizonmentioning

confidence: 96%

Cost-Effectiveness of Sensor-Augmented Pump Therapy in Adults with Type 1 Diabetes in the United States

Kamble

Reed

2012

Value in Health

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“…Se ha demostrado costo-efectividad del tratamiento con ICSI comparado a MDI al analizar el control metabólico, la menor tasa de HS, prevención de complicaciones crónicas y mejor calidad de vida [40][41][42][43][44] .…”

Section: Costosunclassified

De la bomba de insulina y el monitoreo continuo de glucosa al páncreas artificial

2017

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, época en que se utilizó por primera vez un infusor continuo subcutáneo de insulina (ICSI), también conocido como bomba de insulina. En la siguiente década surgió el monitoreo continuo de glucosa (MCG), que permite medir glicemia intersticial en forma continua. Inicialmente el MCG era usado sólo como examen solicitado por el médico y analizado en forma retrospectiva; posteriormente fueron desarrollados equipos que informan niveles de glicemia en tiempo real (MCG-TR).Hace una década que ICSI y MCG fueron unidos en un sólo dispositivo que tiene la capacidad de infundir insulina y también medir glicemia intersticial, dando paso a lo que se conoce como Sensor-Augmented Pump Therapy (SAPT). Estos equipos inicialmente no tenían un programa que permitiera suspender el aporte de insulina ante hipoglicemia, pero actualmente existen modelos de SAPT que interrumpen automáticamente la infusión de insulina frente a la predicción de hipoglicemia, tecnología conocida como integrada.Durante la última década las investigaciones en nuevas tecnologías se han centrado en el desarrollo del páncreas artificial, en que existe un programa computacional que permite aumentar o disminuir el aporte de insulina según los valores de glicemia obtenidos en el MCG.Este artículo tiene como objetivo describir el estado actual de las tecnologías disponibles y en desarrollo para los pacientes con diabetes, así como aquéllas en vías de comercialización, como es el caso del primer sistema híbrido aprobado para uso clínico.

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A Cost-Effectiveness Analysis of Continuous Subcutaneous Insulin Injection versus Multiple Daily Injections in Type 1 Diabetes Patients: A Third-Party US Payer Perspective

Abstract: Setting the willingness to pay at $50,000/QALY, the analysis demonstrated that CSII is a cost-effective option for patients with T1DM in the United States.

Cited by 40 publications

References 32 publications

Short-Term Effects of Continuous Subcutaneous Insulin Infusion Therapy in Perioperative Patients with Diabetes Mellitus

Short-Term Effects of Continuous Subcutaneous Insulin Infusion Therapy in Perioperative Patients with Diabetes Mellitus

Cost-Effectiveness of Sensor-Augmented Pump Therapy in Adults with Type 1 Diabetes in the United States

De la bomba de insulina y el monitoreo continuo de glucosa al páncreas artificial

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