Md1 Health Economic Analysis of Continuous Subcutaneous Insulin Infusion Compared to Multiple Daily Injections for the Treatment of Type 1 Diabetes in Poland

Cost‐effectiveness of continuous subcutaneous insulin infusion versus multiple daily injections of insulin in Type 1 diabetes: a systematic review

“…Of the included studies, nine were performed using the CORE (Center for Outcomes Research) Diabetes Model (CDM) [17,18,[20][21][22][23][25][26][27] and two used Markov model analyses of CSII vs. MDI [19,24]. Cost-effectiveness analyses of CSII were performed in a number of different settings, including four from the UK [19,21,23,24], and one each from the USA [25], Canada [26], Australia [18], Spain [20], Denmark [22], Italy [27] and Poland [17]. Additionally, our search identified a cost-effectiveness analysis of CSII vs. MDI in Type 2 diabetes, and thus not included in the current review; this was conducted in a Chinese setting [28].…”

“…When limited to full text publications scores ranged from 17 to 24, with a total of seven analyses having a score of ≥ 20. Overall, seven studies scored ≥ 20 [18,20,[22][23][24][25][26], with the remainder of studies scoring < 20 [17,19,21,27]. Results of the quality assessment should be interpreted with caution because not all checklist items are applicable to all studies.…”

“…The mean (95% CI) ICER was €30 862 (17 997-43 727 The consensus among studies performed using the CDM (including analyses from the UK, USA, Canada, Denmark, Spain, Australia, Italy and Poland) was that CSII is costeffective relative to MDI, with the ICER falling below generally accepted willingness-to-pay thresholds for costeffectiveness (Table 2). Three studies performed using the CDM investigated the cost-effectiveness of CSII in both adult and adolescent populations [17,18,25]. Interestingly, in the Polish analysis by Clegg et al [17], the ICER was lower in adolescents than in adults (€18 670 vs. 25 917 per QALY gained; $24 285 vs. 33 711 per QALY gained).…”

“…Three studies performed using the CDM investigated the cost-effectiveness of CSII in both adult and adolescent populations [17,18,25]. Interestingly, in the Polish analysis by Clegg et al [17], the ICER was lower in adolescents than in adults (€18 670 vs. 25 917 per QALY gained; $24 285 vs. 33 711 per QALY gained). In contrast, in an analysis in a US setting by St Charles et al [25], CSII was more cost-effective in adults than in adolescent patients (€23 464 vs. 14 661 per QALY gained; $30 520 vs. 19 069 per QALY gained).…”

“…A further four cost-effectiveness analyses were excluded because two abstract/posters and one health technology assessment located via hand searches presented the same data as later full publications identified in the database searches and one publication compared sensor augmented pump therapy (rather than CSII) with MDI. Summary findings and review of the remaining 11 costeffectiveness analyses in patients with Type 1 diabetes were performed by narrative synthesis and calculation of mean cost-effectiveness outcomes (Tables 1 and 2) [17][18][19][20][21][22][23][24][25][26][27]. Of the included studies, nine were performed using the CORE (Center for Outcomes Research) Diabetes Model (CDM) [17,18,[20][21][22][23][25][26][27] and two used Markov model analyses of CSII vs. MDI [19,24].…”