Short-Term Economic Benefits of and Advanced Hybrid Closed-Loop System in People With Type 1 Diabetes and Above-Target HBA1C in France

OBJECTIVES: Improved glycaemic control, measured by HbA1c, is associated with reduced diabetes-related complication risks. The use of an advanced hybrid closed-loop (AHCL) system with automated basal and bolus correction insulin delivery, improves glycaemic outcomes in a cost-effective manner for people with type 1 diabetes (T1D) with above-target HbA1c, in France. As AHCL is associated with higher costs, this study’s aim was to assess the potential short-term economic benefits of adopting AHCL for T1D from a French healthcare system perspective.

METHODS: A previously published probabilistic budget impact model with a 5-year time horizon was used[1]. Complications cost data were derived from published literature and inflated to 2023 prices. Clinical inputs were sourced from a regression model developed based on the results of a prospective, multicentre, randomized control trial[2]. The cost savings modelled through 5 years were converted into average per person per year.

RESULTS: With AHCL use, HbA1c decreased from 9% to 7.38%. This improvement in glycaemic control would potentially lead to a ~46% reduction in vascular complications and ~70% reduction in diabetic ketoacidosis event rate, yielding €2794 per person cumulative savings in complications avoided over 5 years. When annualized, the results corresponded to an average savings of €559 per person per year in complications avoided.

CONCLUSIONS: The improved glycaemic control with AHCL can be translated into potential cost savings thanks to reduced complications cost. Therefore, higher AHCL therapy acquisition costs can be partially offset, even in a 5-year time horizon. These findings complement the longer-term cost-utility results of AHCL, suggesting it also offers good short-term monetary value for people with T1D and above-target HbA1c in France.

[2] Choudhary P, et al. Lancet Diabetes Endocrinol. 2022;10(10):720-731.