Clinical and economic benefits of integrated pump/CGM technology therapy in patients with type 1 diabetes in Colombia

Endocrinol Nutr. 2016 Nov;63(9):466-474. doi: 10.1016/j.endonu.2016.05.011. Epub 2016 Aug 30.
[Article in English, Spanish]

Abstract

Objective: To assess the long-term clinical and economic impact of integrated pump/CGM technology therapy as compared to multiple daily injections (MDI), for the treatment of type 1 diabetes (T1D) in Colombia.

Methods: The CORE Diabetes Model was used to simulate a hypothetical cohort of patients with T1D. Mean baseline characteristics were taken from a clinical study conducted in Colombia and a healthcare payer perspective was adopted, with a 5% annual discount rate applied to both costs and outcomes.

Results: The integrated pump/CGM improved mean life expectancy by 3.51 years compared with MDI. A similar increase occurred in mean quality-adjusted life expectancy with an additional 3.81 quality-adjusted life years (QALYs). Onset of diabetes-related complications was also delayed as compared to MDI, and mean survival time free of complication increased by 1.74 years with integrated pump/CGM. Although this increased treatment costs of diabetes as compared to MDI, savings were achieved thanks to reduced expenditure on diabetes-related complications. The estimated incremental cost-effectiveness ratio (ICER) for SAP was Colombian Pesos (COP) 44,893,950 (approximately USD$23,200) per QALY gained.

Conclusions: Improved blood glucose control associated to integrated pump/CGM results in a decreased incidence of diabetes-related complications and improves life expectancy as compared to MDI. Using recommended thresholds from the World Health Organization and previous coverage decisions about health technologies in Colombia, it is a cost-effective alternative to MDI for the treatment of type 1 diabetes in Colombia.

Keywords: Análisis de coste-efectividad; Continuous glucose monitoring; Cost-effectiveness analysis; Decision modeling; Diabetes tipo 1; Insulin infusion systems; Modelamiento de decisiones.; Monitorización continua de glucosa; Sistemas de infusión de insulina; Type 1 diabetes.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose Self-Monitoring / economics
  • Blood Glucose Self-Monitoring / methods*
  • Colombia
  • Cost-Benefit Analysis
  • Diabetes Complications / economics
  • Diabetes Complications / prevention & control
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / economics
  • Disease Progression
  • Female
  • Humans
  • Infusion Pumps, Implantable
  • Injections, Subcutaneous
  • Insulin Infusion Systems* / economics
  • Male
  • Markov Chains
  • Middle Aged
  • Models, Biological
  • Young Adult