Stéphane Roze1, Jayne Smith-Palmer2, William Valentine2, Vincent Payet3, Simona de Portu4, Natalie Papo4, Michel Cucherat5, Helene Hanaire6. 1. 1 HEVA HEOR , Lyon, France . 2. 2 Ossian Health Economics and Communications , Basel, Switzerland . 3. 3 Department of Health Economics & Reimbursement, Medtronic France SAS , Boulogne Billancourt, France . 4. 4 Medtronic International Trading Sàrl , Tolochenaz, Switzerland . 5. 5 UMR CNRS 5558, Laënnec Faculty of Medicine , Lyon, France . 6. 6 Department of Cardiovascular & Metabolic, Toulouse University Hospital Center , Toulouse, France .
Abstract
BACKGROUND: Sensor-augmented pump therapy (SAP) provides a useful adjunct relative to continuous subcutaneous insulin infusion (CSII) alone. It can provide early warning of the onset of hyperglycemia and hypoglycemia and has the functionality to suspend insulin delivery if sensor glucose levels fall below a predefined threshold. The aim was to assess the cost-effectiveness of SAP with low glucose suspend (LGS) versus CSII alone in type 1 diabetes. MATERIALS AND METHODS: Cost-effectiveness analysis was performed using the CORE Diabetes Model, using published clinical input data. The analysis was performed in two cohorts: one with uncontrolled glycated hemoglobin at baseline and one at elevated risk for hypoglycemic events. The analysis was conducted from a healthcare payer perspective over a lifetime time horizon; future costs and clinical outcomes were discounted at 4% per annum. RESULTS: In patients with uncontrolled glycated hemoglobin at baseline, SAP + LGS resulted in improved discounted quality-adjusted life expectancy (QALE) versus CSII (10.55 quality-adjusted life-years [QALYs] vs. 9.36 QALYs) but higher mean lifetime direct costs (€84,972 vs. €49,171) resulting in an incremental cost-effectiveness ratio (ICER) of €30,163 per QALY gained. In patients at elevated risk for hypoglycemia, the ICER was €22,005 per QALY gained for SAP + LGS versus CSII as lifetime costs were higher (€88,680 vs. €57,097), but QALE was also higher (18.46 QALYs vs. 18.30 QALYs). CONCLUSIONS: In France, projected improvements in outcomes with SAP + LGS versus CSII translated into an ICER generally considered as good value for money, particularly in patients who experience frequent and/or problematic hypoglycemic events.
BACKGROUND: Sensor-augmented pump therapy (SAP) provides a useful adjunct relative to continuous subcutaneous insulin infusion (CSII) alone. It can provide early warning of the onset of hyperglycemia and hypoglycemia and has the functionality to suspend insulin delivery if sensor glucose levels fall below a predefined threshold. The aim was to assess the cost-effectiveness of SAP with low glucose suspend (LGS) versus CSII alone in type 1 diabetes. MATERIALS AND METHODS: Cost-effectiveness analysis was performed using the CORE Diabetes Model, using published clinical input data. The analysis was performed in two cohorts: one with uncontrolled glycated hemoglobin at baseline and one at elevated risk for hypoglycemic events. The analysis was conducted from a healthcare payer perspective over a lifetime time horizon; future costs and clinical outcomes were discounted at 4% per annum. RESULTS: In patients with uncontrolled glycated hemoglobin at baseline, SAP + LGS resulted in improved discounted quality-adjusted life expectancy (QALE) versus CSII (10.55 quality-adjusted life-years [QALYs] vs. 9.36 QALYs) but higher mean lifetime direct costs (€84,972 vs. €49,171) resulting in an incremental cost-effectiveness ratio (ICER) of €30,163 per QALY gained. In patients at elevated risk for hypoglycemia, the ICER was €22,005 per QALY gained for SAP + LGS versus CSII as lifetime costs were higher (€88,680 vs. €57,097), but QALE was also higher (18.46 QALYs vs. 18.30 QALYs). CONCLUSIONS: In France, projected improvements in outcomes with SAP + LGS versus CSII translated into an ICER generally considered as good value for money, particularly in patients who experience frequent and/or problematic hypoglycemic events.
Authors: M Adamo; R Codella; F Casiraghi; A Ferrulli; C Macrì; E Bazzigaluppi; I Terruzzi; L Inverardi; C Ricordi; L Luzi Journal: Cell Transplant Date: 2016-09-20 Impact factor: 4.064
Authors: Stephané Roze; Jayne Smith-Palmer; Simona de Portu; Alexis Delbaere; Bonnie de Brouwer; Harold W de Valk Journal: Clinicoecon Outcomes Res Date: 2019-01-14
Authors: Thomas Danne; Revital Nimri; Tadej Battelino; Richard M Bergenstal; Kelly L Close; J Hans DeVries; Satish Garg; Lutz Heinemann; Irl Hirsch; Stephanie A Amiel; Roy Beck; Emanuele Bosi; Bruce Buckingham; Claudio Cobelli; Eyal Dassau; Francis J Doyle; Simon Heller; Roman Hovorka; Weiping Jia; Tim Jones; Olga Kordonouri; Boris Kovatchev; Aaron Kowalski; Lori Laffel; David Maahs; Helen R Murphy; Kirsten Nørgaard; Christopher G Parkin; Eric Renard; Banshi Saboo; Mauro Scharf; William V Tamborlane; Stuart A Weinzimer; Moshe Phillip Journal: Diabetes Care Date: 2017-12 Impact factor: 19.112