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在瑞典,与1型糖尿病的标准治疗相比,智能胰岛素笔以更低成本带来更好的临床结果:一项成本效益分析。

Smart Insulin Pens are Associated with Improved Clinical Outcomes at Lower Cost Versus Standard-of-Care Treatment of Type 1 Diabetes in Sweden: A Cost-Effectiveness Analysis.

作者信息

Jendle Johan, Ericsson Åsa, Gundgaard Jens, Møller Jonas Bech, Valentine William J, Hunt Barnaby

机构信息

Institute of Medical Sciences, Örebro University, Örebro, Sweden.

Novo Nordisk Scandinavia AB, Malmö, Sweden.

出版信息

Diabetes Ther. 2021 Jan;12(1):373-388. doi: 10.1007/s13300-020-00980-1. Epub 2020 Dec 11.

Abstract

INTRODUCTION

Real-world evidence has demonstrated improved glycemic control and insulin management following introduction of smart insulin pens in a Swedish type 1 diabetes (T1D) population. To understand the implications for healthcare costs and expected health outcomes, this analysis evaluated the long-term cost-effectiveness of introducing smart insulin pens to standard-of-care T1D treatment (standard care) from a Swedish societal perspective.

METHODS

Clinical outcomes and healthcare costs (in 2018 Swedish krona, SEK) were projected over patients' lifetimes using the IQVIA CORE Diabetes Model to estimate cost-effectiveness. Clinical data and baseline characteristics for the simulated cohort were informed by population data and a prospective, noninterventional study of a smart insulin pen in a Swedish T1D population. This analysis captured direct and indirect costs, mortality, and the impact of diabetes-related complications on quality of life.

RESULTS

Over patients' lifetimes, smart insulin pen use was associated with per-patient improvements in mean discounted life expectancy (+ 0.90 years) and quality-adjusted life expectancy (+ 1.15 quality-adjusted life-years), in addition to mean cost savings (direct, SEK 124,270; indirect, SEK 373,725), versus standard care. A lower frequency and delayed onset of complications drove projected improvements in quality-adjusted life expectancy and lower costs with smart insulin pens versus standard care. Overall, smart insulin pens were a dominant treatment option relative to standard care across all base-case and sensitivity analyses.

CONCLUSIONS

Use of smart insulin pens was projected to improve clinical outcomes at lower costs relative to standard care in a Swedish T1D population and represents a good use of healthcare resources in Sweden.

摘要

引言

真实世界证据表明,在瑞典1型糖尿病(T1D)人群中引入智能胰岛素笔后,血糖控制和胰岛素管理得到了改善。为了解其对医疗成本和预期健康结果的影响,本分析从瑞典社会角度评估了将智能胰岛素笔引入T1D标准治疗(标准护理)的长期成本效益。

方法

使用艾昆纬CORE糖尿病模型预测患者一生中的临床结果和医疗成本(以2018年瑞典克朗,SEK计),以估计成本效益。模拟队列的临床数据和基线特征来自人口数据以及一项针对瑞典T1D人群的智能胰岛素笔前瞻性非干预性研究。该分析涵盖了直接和间接成本、死亡率以及糖尿病相关并发症对生活质量的影响。

结果

与标准护理相比,在患者的一生中,使用智能胰岛素笔可使每位患者的平均贴现预期寿命提高(+0.90年),质量调整预期寿命提高(+1.15质量调整生命年),同时平均成本节省(直接成本,124,270瑞典克朗;间接成本,373,725瑞典克朗)。与标准护理相比,并发症发生频率降低和发病延迟推动了智能胰岛素笔在质量调整预期寿命方面的改善以及成本降低。总体而言,在所有基础案例和敏感性分析中,相对于标准护理,智能胰岛素笔是一种占优的治疗选择。

结论

预计在瑞典T1D人群中,使用智能胰岛素笔相对于标准护理能够以更低的成本改善临床结果,并且在瑞典是对医疗资源的良好利用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2624/7843677/557d097f7451/13300_2020_980_Fig1_HTML.jpg

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