Cost-effectiveness of Simple Insulin Infusion Devices Compared to Multiple Daily Injections in Uncontrolled Type 2 Diabetics in the United States Based on a Simulation Model

Journal of Health Economics and Outcomes Research
Peter WahlqvistRobert Morlock

Abstract

As type 2 diabetes (T2D) progresses, administering basal and bolus insulin through multiple daily injections (MDI) is often required to achieve target control, although many people fail to achieve target levels. Continuous subcutaneous insulin infusion (CSII) treatment with traditional pumps has proven effective in this population, but use remains limited in T2D due to CSII cost and complexity. A new class of simple insulin infusion devices have been developed which are simpler to use and less expensive. This paper assesses at what price one such simple insulin infusion device, PAQ® (Cequr SA, Switzerland), may be cost-effective compared to MDI in people with T2D not in glycemic control in the United States. Published equations were used in a simulation model to project long-term cost-effectiveness over 40 years, combined with data from the recent OpT2mise study, assuming similar efficacy of CSII and simple insulin infusion. Cost-effectiveness was pre-defined in relation to per capita gross domestic product (GDP), where incremental cost-effectiveness ratios below 1X the per capita GDP per quality-adjusted life year (QALY) gained were defined as "highly cost-effective" and below 3X GDP per capita as "cost-effective." Simple insu...Continue Reading

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Citations

Apr 29, 2021·Journal of Diabetes·Nirali A Shah, Carol J Levy
May 6, 2021·Diabetes, Obesity & Metabolism·Aideen Daly, Roman Hovorka
Jun 23, 2021·Journal of Medical Economics·Timothy KwaSarnath Chattaraj

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