Department of Bioengineering and iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
The Discoveries Center for Regenerative and Precision Medicine, Lisbon Campus, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
Curr Diab Rep. 2019 Aug 2;19(9):75. doi: 10.1007/s11892-019-1203-9.
Type 1 diabetes impacts 1.3 million people in the USA with a total direct lifetime medical cost of $133.7 billion. Management requires a mix of daily exogenous insulin administration and frequent glucose monitoring. Decision-making by the individual can be burdensome.
Beta-cell replacement, which involves devices protecting cells from autoimmunity and allo-rejection, aims at restoring physiological glucose regulation and improving clinical outcomes in patients. Given the significant burden of T1D in the healthcare systems, cost-effectiveness analyses can drive innovation and policymaking in the area. This review presents the health economics analyses performed for donor-derived islet transplantation and the possible outcomes of stem cell-derived beta cells. Long-term cost-effectiveness of islet transplantation depends on the engraftment of these transplants, and the expenses and thresholds assumed by healthcare systems in different countries. Early health technology assessment analyses for stem cell-derived beta-cell replacement suggest manufacturing optimization is necessary to reduce upfront costs.
美国有 1337 亿美元的直接终生医疗费用，影响了 130 万 1 型糖尿病患者。管理需要结合日常外源性胰岛素给药和频繁的血糖监测。个人的决策可能会带来负担。
β细胞替代疗法包括保护细胞免受自身免疫和同种异体排斥的设备，旨在恢复生理葡萄糖调节，改善患者的临床结果。鉴于 T1D 在医疗保健系统中的巨大负担，成本效益分析可以推动该领域的创新和决策制定。本综述介绍了用于供体衍生胰岛移植的健康经济学分析以及干细胞衍生β细胞的可能结果。胰岛移植的长期成本效益取决于这些移植的植入情况，以及不同国家的医疗保健系统所承担的费用和阈值。干细胞衍生β细胞替代物的早期卫生技术评估分析表明，有必要进行制造优化以降低前期成本。
