Department of Pediatrics, The hospital of Halland Kungsbacka, Kungsbacka, Sweden.
Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Diabet Med. 2024 Nov;41(11):e15432. doi: 10.1111/dme.15432. Epub 2024 Sep 6.
The present analysis estimated the cost-effectiveness of treatment with the Tandem t: slim X2 insulin pump with Control IQ technology (CIQ) in children with type 1 diabetes in Sweden.
A four-state Markov model and probabilistic sensitivity analyses (PSA) were used to assess the cost-effectiveness of CIQ use compared with treatment with multiple daily insulin injections (MDI) or continuous subcutaneous insulin infusion (CSII) in conjunction with CGM. Data sources included clinical input data from a recent retrospective, observational study, cost data from local diabetes supply companies and government agencies, and published literature. Outcomes measures were quality adjusted life years (QALYs) at 10, 20 and 30-year time horizons based on cost per QALY and incremental cost-effectiveness ratio (ICER).
A total of 84 type 1 diabetes children were included (CIQ, n = 37; MDI, n = 19; CSII, n = 28). For all time horizons, the use of CIQ was a dominant strategy (e.g. more effective and less costly) compared with MDI or CSII use: 10-year ICER, SEK -88,010.37 and SEK -91,723.92; 20-year ICER, SEK -72,095.33 and SEK -87,707.79; and 30-year ICER, SEK -65,573.01 and SEK -85,495.68, respectively. PSA confirmed that CIQ use was less costly compared with MDI and CSII.
Initiation of CIQ use in children with type 1 diabetes is cost-saving, besides previously shown improved glycaemic control, and increased quality of life. Further investigations are needed to more fully elucidate the cost-effectiveness of these technologies in different countries with existing differences in payment models.
本分析旨在评估在瑞典，1 型糖尿病儿童使用具有控制智能（CIQ）技术的 Tandem t：slim X2 胰岛素泵的成本效益。
采用四状态马尔可夫模型和概率敏感性分析（PSA），评估与多次胰岛素注射（MDI）或连续皮下胰岛素输注（CSII）联合 CGMS 治疗相比，CIQ 使用的成本效益。数据来源包括最近回顾性观察研究的临床输入数据、来自当地糖尿病供应公司和政府机构的成本数据以及已发表的文献。结果衡量指标为基于成本-效用比（QALY）和增量成本效益比（ICER）的 10、20 和 30 年时间范围内的质量调整生命年（QALY）。
共纳入 84 名 1 型糖尿病儿童（CIQ，n=37；MDI，n=19；CSII，n=28）。在所有时间范围内，与 MDI 或 CSII 相比，CIQ 的使用是一种占主导地位的策略（例如更有效且成本更低）：10 年 ICER，SEK-88010.37 和 SEK-91723.92；20 年 ICER，SEK-72095.33 和 SEK-87707.79；30 年 ICER，SEK-65573.01 和 SEK-85495.68。PSA 证实，与 MDI 和 CSII 相比，CIQ 的使用成本更低。
在 1 型糖尿病儿童中启动 CIQ 的使用不仅具有成本效益，还可以改善血糖控制和提高生活质量，除此之外，先前已经证明了这一点。需要进一步研究以更全面地阐明这些技术在不同国家的成本效益，因为这些国家的支付模式存在差异。
