A Systematic Review of Cost-Effectiveness Models in Type 1 Diabetes Mellitus

Abstract

Several models have been developed that provide useful insight into T1DM modelling. Based on a review of the models identified in this study, we identified a set of 'best in class' methods for the different technical aspects of T1DM modelling.

A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial

“…Most health economic models of T1DM estimate the cost-effectiveness by primarily modifying HbA 1c levels, which subsequently affect the risk of diabetic complications. 88 However, it is important to note that HbA 1c may not have fallen in patients who entered the trial with low baseline levels of HbA 1c , but who might have been experiencing frequent hypoglycaemia or wished to increase dietary freedom. Success for such individuals would be a HbA 1c level that is maintained, or even rises slightly, with a reduction in the frequency of hypoglycaemia.…”

Assessing the economic value of maintained improvements in Type 1 diabetes management, in terms of HbA1c, weight and hypoglycaemic event incidence

“…By simulating disease progression over a time horizon longer than that feasible in clinical trials, computer modelling represents an important tool to quantify the long‐term health economic outcomes of Type 1 diabetes interventions, and support clinical and reimbursement decision‐making 9. In this study, the value of modest improvements in disease management was quantified using the Cardiff Type 1 Diabetes Model, implemented with risk equations partially derived from DCCT/EDIC study data 10.…”

“…In brief, it is a fixed‐time‐increment stochastic microsimulation model designed to evaluate the lifetime impact of therapeutic changes for individuals with Type 1 diabetes. Consistent with both established and recently published Type 1 diabetes models 9, risk equations implemented within the Cardiff Type 1 Diabetes Model were adapted to incorporate long‐term epidemiological evidence derived from the Diabetes Control and Complications Trial (DCCT) 10 and follow‐up study (Epidemiology of Diabetes Interventions and Complications; EDIC) 11, in addition to cardiovascular risk equations from the Swedish National Diabetes Registry 12. A flow diagram of the Cardiff Type 1 Diabetes Model is shown in Fig.…”

Intraductal papillary mucinous neoplasms of the pancreas – a cost-effectiveness analysis of management strategies for the branch-duct subtype

“…40 The average cost of complications related to diabetes was estimated from a previous model. 41 There exist plenty of different models for cost-effectiveness analysis in diabetes, 42 but we did only include an annual cost and a static decrease of health utility in our model. Despite a limited followup, studies following total pancreatectomy show that deaths due to diabetic complications are rare in modern medicine.…”