{"title":"MiniMed 780G系统治疗1型糖尿病的成本效益","authors":"Mallika Kommareddi, Kael Wherry","doi":"10.37765/ajmc.2025.89722","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Advances in diabetes technology have led to improved glycemic control. However, no study has evaluated the economic impact of advanced hybrid closed-loop (AHCL) technology in the US compared with older and less expensive treatments. We assessed the cost-effectiveness of the MiniMed 780G system (MM780G) with AHCL technology vs multiple daily injections of insulin (MDI) with intermittently scanned continuous glucose monitoring (isCGM) among patients with type 1 diabetes (T1D) in the US.</p><p><strong>Study design: </strong>A 6-month randomized controlled trial compared MM780G against MDI with isCGM among patients with T1D. Outcomes included changes in hemoglobin A 1c and quality of life.</p><p><strong>Methods: </strong>We used the IQVIA Core Diabetes Model to simulate direct costs and quality of life separately over a 4-year horizon and a lifetime horizon. Treatment effects were sourced from the randomized controlled trial, and utilities and disutilities for diabetes-related complications came from the literature. We generated incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves for the base case and 5 one-way sensitivity analyses.</p><p><strong>Results: </strong>At a willingness-to-pay threshold of $100,000, MM780G is cost-effective in the base case, with an ICER of $68,402 per quality-adjusted life-year over a 4-year horizon and $38,842 per quality-adjusted life-year over a lifetime horizon. Sensitivity analyses varying the rates of short-term complications, pricing, and assumptions about treatment-related utilities show cost-effectiveness at a threshold of $100,000 in all but 1 case.</p><p><strong>Conclusions: </strong>MM780G is likely to be cost-effective vs MDI with isCGM in patients with T1D in the US at a willingness-to-pay threshold of $100,000.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"31 4","pages":"e79-e86"},"PeriodicalIF":2.5000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cost-effectiveness of the MiniMed 780G system for type 1 diabetes.\",\"authors\":\"Mallika Kommareddi, Kael Wherry\",\"doi\":\"10.37765/ajmc.2025.89722\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Advances in diabetes technology have led to improved glycemic control. However, no study has evaluated the economic impact of advanced hybrid closed-loop (AHCL) technology in the US compared with older and less expensive treatments. We assessed the cost-effectiveness of the MiniMed 780G system (MM780G) with AHCL technology vs multiple daily injections of insulin (MDI) with intermittently scanned continuous glucose monitoring (isCGM) among patients with type 1 diabetes (T1D) in the US.</p><p><strong>Study design: </strong>A 6-month randomized controlled trial compared MM780G against MDI with isCGM among patients with T1D. Outcomes included changes in hemoglobin A 1c and quality of life.</p><p><strong>Methods: </strong>We used the IQVIA Core Diabetes Model to simulate direct costs and quality of life separately over a 4-year horizon and a lifetime horizon. Treatment effects were sourced from the randomized controlled trial, and utilities and disutilities for diabetes-related complications came from the literature. We generated incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves for the base case and 5 one-way sensitivity analyses.</p><p><strong>Results: </strong>At a willingness-to-pay threshold of $100,000, MM780G is cost-effective in the base case, with an ICER of $68,402 per quality-adjusted life-year over a 4-year horizon and $38,842 per quality-adjusted life-year over a lifetime horizon. Sensitivity analyses varying the rates of short-term complications, pricing, and assumptions about treatment-related utilities show cost-effectiveness at a threshold of $100,000 in all but 1 case.</p><p><strong>Conclusions: </strong>MM780G is likely to be cost-effective vs MDI with isCGM in patients with T1D in the US at a willingness-to-pay threshold of $100,000.</p>\",\"PeriodicalId\":50808,\"journal\":{\"name\":\"American Journal of Managed Care\",\"volume\":\"31 4\",\"pages\":\"e79-e86\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Managed Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.37765/ajmc.2025.89722\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Managed Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.37765/ajmc.2025.89722","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Cost-effectiveness of the MiniMed 780G system for type 1 diabetes.
Objectives: Advances in diabetes technology have led to improved glycemic control. However, no study has evaluated the economic impact of advanced hybrid closed-loop (AHCL) technology in the US compared with older and less expensive treatments. We assessed the cost-effectiveness of the MiniMed 780G system (MM780G) with AHCL technology vs multiple daily injections of insulin (MDI) with intermittently scanned continuous glucose monitoring (isCGM) among patients with type 1 diabetes (T1D) in the US.
Study design: A 6-month randomized controlled trial compared MM780G against MDI with isCGM among patients with T1D. Outcomes included changes in hemoglobin A 1c and quality of life.
Methods: We used the IQVIA Core Diabetes Model to simulate direct costs and quality of life separately over a 4-year horizon and a lifetime horizon. Treatment effects were sourced from the randomized controlled trial, and utilities and disutilities for diabetes-related complications came from the literature. We generated incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves for the base case and 5 one-way sensitivity analyses.
Results: At a willingness-to-pay threshold of $100,000, MM780G is cost-effective in the base case, with an ICER of $68,402 per quality-adjusted life-year over a 4-year horizon and $38,842 per quality-adjusted life-year over a lifetime horizon. Sensitivity analyses varying the rates of short-term complications, pricing, and assumptions about treatment-related utilities show cost-effectiveness at a threshold of $100,000 in all but 1 case.
Conclusions: MM780G is likely to be cost-effective vs MDI with isCGM in patients with T1D in the US at a willingness-to-pay threshold of $100,000.
期刊介绍：
The American Journal of Managed Care is an independent, peer-reviewed publication dedicated to disseminating clinical information to managed care physicians, clinical decision makers, and other healthcare professionals. Its aim is to stimulate scientific communication in the ever-evolving field of managed care. The American Journal of Managed Care addresses a broad range of issues relevant to clinical decision making in a cost-constrained environment and examines the impact of clinical, management, and policy interventions and programs on healthcare and economic outcomes.
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