Evaluating the Impact of Hybrid Closed-Loop Systems (HCLS) on Healthcare Utilization and Costs Compared to Standard of Care Therapy Among Patients with Type 1 Diabetes New to Pump Therapy

Speaker(s)

Manjelievskaia J1, Vaidya N2, Wang SM3, McDermott KW1, Lavelle K1, Wall S1, Bonafede M1, Patel BV3, Stemple C4, Brixner D5, Malone D5
1Veradigm, Raleigh, NC, USA, 2Cencora, Conshohocken, PA, USA, 3Tandem Diabetes Care, San Diego, CA, USA, 4Stemple Medical Consulting, Montgomery, OH, USA, 5University of Utah, Salt Lake City, UT, USA

OBJECTIVES: Hybrid closed-loop systems (HCLS) for insulin delivery may improve glycemic control while decreasing the burden of care compared to multiple daily injection (MDI) therapy in patients with type 1 diabetes (PwT1D). The purpose of this study was to evaluate the impact of HCLS (Tandem t:slim X2 with Control-IQ technology and Medtronic MiniMed 670G) vs MDI on all-cause healthcare resource use (HCRU) and costs among PwT1D.

METHODS: This retrospective observational cohort study used de-identified data from the Veradigm Network electronic health record (EHR) linked to claims and Tandem data to identify PwT1D newly treated with HCLS or MDI between 1/15/20-12/31/20. Earliest treatment claim was index claim and patients had ≥12 months of continuous enrollment prior to and following the index date. HCRU and costs were evaluated during baseline and follow-up. Logistic regression models assessed the odds of having an inpatient (IP) admission or emergency room (ER) visit. A generalized linear model was used to estimate per patient annual adjusted costs. Models controlled for baseline patient demographics, diabetes-related medications, diabetes complications severity index, and IP or ER event for IP and ER models, respectively.

RESULTS: A total of 7,264 and 27,973 patients met inclusion criteria for the HCLS and MDI cohorts, respectively. Mean (SD) age was 27 (17) among HCLS and 34 (18) (p<0.001) in MDI, and 52% and 57% were male (p<0.001), respectively. In adjusted models, the odds of an IP admission for MDI relative to HCLS was 1.63 (CI:1.40-1.91). For an ER visit, the odds ratio was 1.54 (CI: 1.39-1.70) for MDI relative to HCLS. IP and ER costs were $1,845 (p<0.001) and $631 (p<0.001) higher for MDI vs HCLS, respectively.

CONCLUSIONS: PwT1D utilizing HCLS were significantly less likely to experience IP and ER visits and incurred less healthcare costs compared to MDI therapy.

Code

EE125

Topic

Study Approaches

Topic Subcategory

Electronic Medical & Health Records

Disease

Diabetes/Endocrine/Metabolic Disorders (including obesity)