在新加坡,先进的混合闭环系统与 1 型糖尿病标准管理的成本效益比较。

IF 5.7 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetes technology & therapeutics Pub Date : 2024-05-01 Epub Date: 2024-03-22 DOI:10.1089/dia.2023.0455
Daphne Gardner, Mrinmayee Lakkad, Zhiyu Qiu, Yuta Inoue, Suresh Rama Chandran, Kael Wherry
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引用次数: 0

摘要

背景:尽管技术在不断进步,但 1 型糖尿病(T1D)患者的血糖治疗效果仍不理想。MiniMed 780G(MM780G)高级混合闭环系统(AHCL)是治疗 T1D 的最新技术,具有公认的安全性和有效性。本研究探讨了 MM780G AHCL 与每日多次注射(MDI)加间歇扫描 CGM(isCGM)相比的成本效益:采用 IQVIA Core Diabetes Model (CDM) v9.5 对基线 HbA1c 为 8.4% 的 1000 名 T1D 患者的终生结果进行了成本效益分析。从新加坡医疗支付方的角度出发,采用 2023 年的成本。治疗效果来自 ADAPT 研究,治疗相关事件来自多种来源。T1D 并发症成本来自本地文献;健康状态效用和不效用来自公开发表的文献。情景分析和概率敏感性分析 (PSA) 探讨了不确定性。成本效益的评估基于支付意愿(WTP)阈值(设定为每 QALY 45,000 新元)和新加坡人均国内生产总值(GDP)(每 QALY 114,165 新元):从 MDI 加 isCGM 改用 MM780G 后,预期寿命年数(+0.78)和质量调整寿命年数(QALY)(+1.45)均有所提高。通过减少 T1D 并发症而节省的成本(25,465 新元)部分抵消了 AHCL 治疗组较高的治疗成本(+74,538 新元),估计每 QALY 收益的增量成本效益比 (ICER) 为 33,797 新元。研究结果是可靠的,PSA结果表明,在规定的WTP阈值下,成本效益概率分别为81%和99%:结论:MM780G 对于在新加坡接受治疗的 T1D 患者来说是一种具有成本效益的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Cost-Effectiveness of an Advanced Hybrid Closed-Loop System Compared to Standard Management of Type 1 Diabetes in a Singapore Setting.

Background: Despite advances in technology, glycemic outcomes in people with type 1 diabetes (T1D) remain suboptimal. The MiniMed 780G (MM780G) advanced hybrid closed-loop (AHCL) system is the latest technology for T1D management with established safety and efficacy. This study explores the cost-effectiveness of MM780G AHCL compared against multiple daily injections (MDI) plus intermittently scanned continuous glucose monitor (isCGM). Methods: A cost-utility analysis was conducted, simulating lifetime outcomes for 1000 T1D individuals, with baseline hemoglobin A1c of 8.4%, using the IQVIA Core Diabetes Model (CDM) v9.5. A Singapore health care payer perspective was taken with 2023 costs applied. Treatment effects were taken from the ADAPT study and treatment-related events from a combination of sources. T1D complication costs were derived from local literature, and health state utilities and disutilities from published literature. Scenario analyses and probabilistic sensitivity analyses (PSAs) explored uncertainty. Cost-effectiveness was assessed based on willingness-to-pay (WTP) thresholds set to Singapore Dollars (SGD) 45,000 (United States Dollars [USD] 33,087) per quality-adjusted life year (QALY) and Singapore's gross domestic product (GDP) per capita of SGD 114,165 (USD 83,941) per QALY. Results: A switch from MDI plus isCGM to MM780G resulted in expected gains in life-years (+0.78) and QALYs (+1.45). Cost savings through reduction in T1D complications (SGD 25,465; USD 18,723) partially offset the higher treatment costs in the AHCL arm (+SGD 74,538; +USD 54,805), resulting in an estimated incremental cost-effectiveness ratio of SGD 33,797 (USD 24,850) per QALY gained. Findings were robust, with PSA outputs indicating 81% and 99% probabilities of cost-effectiveness at the stated WTP thresholds. Conclusion: MM780G is a cost-effective option for people with T1D managed in a Singapore setting.

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来源期刊
Diabetes technology & therapeutics
Diabetes technology & therapeutics 医学-内分泌学与代谢
CiteScore
10.60
自引率
14.80%
发文量
145
审稿时长
3-8 weeks
期刊介绍: Diabetes Technology & Therapeutics is the only peer-reviewed journal providing healthcare professionals with information on new devices, drugs, drug delivery systems, and software for managing patients with diabetes. This leading international journal delivers practical information and comprehensive coverage of cutting-edge technologies and therapeutics in the field, and each issue highlights new pharmacological and device developments to optimize patient care.
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