Cost-Effectiveness Analysis of an Advanced Hybrid Closed-Loop Insulin Delivery System in People with Type 1 Diabetes in Greece

Lambadiari, Vaia; Zeynep, Ozdemir Saltik, Asli; Portu, Simona de; Buompensiere, Maria Ida; Kountouri, Aikaterini; Korakas, Emmanouil; Sharland, Helen; Cohen, Ohad

doi:10.1089/dia.2021.0443

Cited by 14 publications

(9 citation statements)

References 42 publications

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“…Higher mean lifetime costs were estimated, but these costs were partially mitigated thanks to the reduction in short‐ and long‐term diabetes complications, thus treatment costs in the CSII group were linked to the estimated reductions in diabetes‐related complication costs. These studies showed an incremental cost‐effectiveness ratio (ICER) ranging from €11 612 to €44 982 per QALY gained and an ICER below the willingness‐to‐pay threshold was shown for the following countries: Austria, Denmark, Greece, France, Italy, Poland, Spain, Sweden, the Netherlands, Turkey, and the United Kingdom 13‐35 . Greater reductions in HbA1c and fewer severe hypoglycaemic events lead to improved life expectancy and quality‐adjusted life expectancy over the long term.…”

Section: Cost‐effectiveness Of Insulin Pump Treatment In T1dmentioning

confidence: 99%

“…In several studies in individuals living with T1D, HCL systems have been found to be a cost‐effective treatment option compared with intermittently scanned CGM plus MDI or CSII or SAP 13‐35 (Table 1). In these studies, CSII was associated with a gain in quality‐adjusted life‐years (QALYs) ranging between 0.35 and 3.1 compared with MDI.…”

Section: Cost‐effectiveness Of Insulin Pump Treatment In T1dmentioning

confidence: 99%

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Use of insulin pumps and closed‐loop systems among people living with diabetes: A narrative review of clinical and cost‐effectiveness to enable access to technology and meet the needs of payers

Jendle

Reznik

2023

Diabetes Obesity Metabolism

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The use of continuous subcutaneous insulin infusion (CSII) via insulin pumps is today considered standard of care for type 1 diabetes (T1D). Closed-loop systems combining continuous glucose monitoring with automated algorithm-driven insulin delivery have been shown to be safe and efficacious in randomized controlled trials and reallife studies in both paediatric and adult participants with T1D. Implementation of hybrid closed-loop (HCL) systems has shown incremental effectiveness, with further reduction of hypoglycaemia and hyperglycaemia. Although less extensively studied in type 2 diabetes (T2D), insulin pumps have demonstrated their effectiveness in glucose control, along with a reduction in need for insulin and a neutral effect on weight.Recent studies have also shown promising results with the use of HCL systems in T2D. Cost-effectiveness studies in both T1D and T2D have shown that pump use is cost-effective in several countries, leading to improvements in quality-adjusted lifeyears. Insulin pumps are currently reimbursed for T1D in many European countries, but in only a few for individuals with T2D. HCL systems are to be evaluated in future trials performed in T2D to compare their incremental efficacy and cost-effectiveness in comparison with available intensification tools which include multiple daily insulin injections, metformin, sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists. There is a need for updated guidelines for the use of CSII and HCL in individuals living with T2D based on the emerging evidence, with identification of and recommendations for the people who would benefit the most, which would eventually form a basis for reimbursement and health policies. K E Y W O R D S continuous glucose monitoring (GCM), cost-effectiveness, CSII, insulin pump therapy, type 2 diabetes This article has an accompanied Plain Language Summary in the Supporting Information Data S1.

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Section: Cost‐effectiveness Of Insulin Pump Treatment In T1dmentioning

confidence: 99%

Section: Cost‐effectiveness Of Insulin Pump Treatment In T1dmentioning

confidence: 99%

Use of insulin pumps and closed‐loop systems among people living with diabetes: A narrative review of clinical and cost‐effectiveness to enable access to technology and meet the needs of payers

Jendle

Reznik

2023

Diabetes Obesity Metabolism

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“…Therefore, access to closed-loop therapy remains patchy, as insurers may be reluctant to fund closedloop therapy. Recently, several robust health economic analyses of a variety of closed-loop systems for both children and adults have been published [143,[144][145][146][147]149,150]. Results show hybrid closed-loop therapy to be cost-effective compared to both multiple daily injections and pump therapy combined with intermittently scanned CGM in several European countries.…”

Section: Cost-effectiveness and Equitable Accessmentioning

confidence: 99%

Closed-loop insulin delivery: update on the state of the field and emerging technologies

Ware

Hovorka

2022

Expert Review of Medical Devices

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Introduction:Over the last five years, closed-loop insulin delivery systems have transitioned from research-only to real-life use. A number of systems have been commercialized and are increasingly used in clinical practice. Given the rapidity of new developments in the field, understanding the capabilities and key similarities and differences of current systems can be challenging. This review aims to provide an update on the state of the field of closed-loop insulin delivery systems, including emerging technologies. Areas covered: We summarize key clinical safety and efficacy evidence of commercial and emerging insulin-only hybrid closed-loop systems for type 1 diabetes. A literature search was conducted and clinical trials using closed-loop systems during free-living conditions were identified to report on safety and efficacy data. We comment on emerging technologies and adjuncts for closed-loop systems, as well as non-technological priorities in closed-loop insulin delivery. Expert opinion: Commercial hybrid closed-loop insulin delivery systems are efficacious, consistently improving glycemic control when compared to standard therapy. Challenges remain in widespread adoption due to clinical inertia and the lack of resources to embrace technological developments by health care professionals.

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“…Associated with the studies supporting the improvement of metabolic control with MiniMed 780G 1,9–12 are cost‐utility and cost‐effectiveness studies that recognize the MiniMed 780G system as cost effective compared to isCGM plus MDI or CSII for the treatment of T1D 13,14 …”

Section: Introductionmentioning

confidence: 99%

“…1 Associated with the studies supporting the improvement of metabolic control with MiniMed 780G 1,9-12 are cost-utility and cost-effectiveness studies that recognize the MiniMed 780G system as cost effective compared to isCGM plus MDI or CSII for the treatment of T1D. 13,14 Poor sleep quality is common in adolescents with T1D and their caregivers, probably secondary to fear of hypoglycemia, nocturnal glucose monitoring, hypoglycemia itself, and device alarms. 15 Hybrid closed-loop systems potentially reduce nighttime awakenings and fear of hypoglycemia and improve quality of life.…”

Section: Introductionmentioning

confidence: 99%

Impact on glucometric variables and quality of life of the advanced hybrid closed‐loop system in pediatric and adolescent type 1 diabetes

Lendínez‐Jurado,

Gómez‐Perea,

Ariza‐Jiménez

et al. 2023

Journal of Diabetes

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Background: In recent years, technological advances in the field of diabetes have revolutionized the management, prognosis, and quality of life of diabetes patients and their environment. The aim of our study was to evaluate the impact of implementing the MiniMed 780G closed-loop system in a pediatric and adolescent population previously treated with a continuous subcutaneous insulin infusion pump and intermittent glucose monitoring. Methods: Data were collected from 28 patients with type 1 diabetes aged 6 to 17 years, with a follow-up of 6 months. We included both glucometric and quality of life variables, as well as quality of life in primary caregivers. Metabolic control variables were assessed at baseline (before system change) and at different cutoff points after initiation of the closedloop system (48 hours, 7 days, 14 days, 21 days, 1 month, 3 months, 6 months). Results: Time in range 70-180 mg/dL increased from 59.44% at baseline to 74.29% in the first 48 hours after automation of the new system, and this improvement was maintained at the other cutoff points, as was time in hyperglycemia 180-250 mg/dL (24.44% at baseline to 18.96% at 48 hours) and >250 mg/dL (11.71% at baseline to 3.82% at 48 hours). Conclusions: Our study showed an improvement in time in range and in all time spent in hyperglycemia from the first 48 hours after the automation of the system, which was maintained at 6 months. K E Y W O R D S pediatric type 1 diabetes, advanced hybrid closed-loop, time in range, time in hyperglycemia, MiniMed 780G

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Cost-Effectiveness Analysis of an Advanced Hybrid Closed-Loop Insulin Delivery System in People with Type 1 Diabetes in Greece

Cited by 14 publications

References 42 publications

Use of insulin pumps and closed‐loop systems among people living with diabetes: A narrative review of clinical and cost‐effectiveness to enable access to technology and meet the needs of payers

Use of insulin pumps and closed‐loop systems among people living with diabetes: A narrative review of clinical and cost‐effectiveness to enable access to technology and meet the needs of payers

Closed-loop insulin delivery: update on the state of the field and emerging technologies

Impact on glucometric variables and quality of life of the advanced hybrid closed‐loop system in pediatric and adolescent type 1 diabetes

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