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

Abstract

Despite superior clinical benefits of SAPT compared with MDI, SAPT does not appear to be economically attractive in the United States for adults with type 1 diabetes in its current state of development. However, further clinical developments reducing disposable costs of the system could significantly improve its economic attractiveness.

Evaluation of the cost-utility of insulin degludec vs insulin glargine in Sweden

“…A key advantage of the present analysis is the simplicity and transparency of the model used to evaluate cost-utility. The majority of published cost-utility analyses of both type 1 and type 2 diabetes interventions have taken a long-term perspective, evaluating clinical and cost outcomes over patient lifetimes [32][33][34][35] . A long-term modeling approach is consistent with the progression of diabetes, with diabetesrelated complications in the future having a significant impact on quality-of-life and medical costs.…”

Continuous Glucose Monitoring and Global Reimbursement: An Update

“…33 In the past decade, eight publications have examined the cost-effectiveness of the RT-CGM in patients with T1DM (Table 2). [34][35][36][37][38][39][40][41] The results of these studies are presented in terms of cost per qualityadjusted life year (QALY) or cost per hypoglycemic event avoided. Results are wide ranging, possibly because of differences in assumptions that form the basis of the models.…”

“…It is important to note that only two of the eight published CEAs evaluated standalone RT-CGM, 34,37 whereas others evaluated sensor-augmented pump therapy 35,36,[38][39][40][41] ; the CEA performed by Huang et al was based on outcomes from the Juvenile Diabetes Research Foundation trial, in which intervention group patients could have received either sensoraugmented insulin pump therapy or MDIs plus RT-CGM.…”

Insulin Pump Termination in Adult Patients

“…The basic principle for the improvement of the economic aspect of CSII treatment is the individual approach, selection of suitable patients, frequent assessment of treatment efficacy and lack of concern about continuity disruption (not hesitate to terminate the treatment if ineffective). The benefit of upgrading the treatment by sensors is also disputable; glycemic control improvement was demonstrated clinically [11,15], however, the costs of a treatment that could have been a standard by now are currently too high [16].…”