Impact of Automated Insulin Delivery System (AID) Adoption on Concomitant Non-Insulin Diabetes Medications in Patients With Type 2 Diabetes for a U.S. Payer

OBJECTIVES: Complex drug therapies, comorbidities, and older age contribute to an increased risk for polypharmacy (use of ≥5 medications) for PwT2D. Polypharmacy increases safety risks, such as adverse events, drug-drug interactions, emergency room visits, and hospitalizations. T:slim X2 with Control-IQ technology (CIQ), an AID, may reduce concomitant use of non-insulin diabetes medications which may also translate to cost savings.To model per-member-per-month (PMPM) impact of changes in concomitant medication use among PwT2D switching from multiple daily injections (MDI) to CIQ.
METHODS: Published real-world utilization data from a national payer database that includes PwT2D on MDI and CIQ were used to model cost outcomes for a payer with 1M lives. Absolute change in concomitant non-insulin diabetes medication use from baseline to 1-Yr follow-up, by drug class, ranged from -3.1% to 4.3% and -9.2% to -1.4% for MDI and CIQ, respectively. Scenarios using 25% and 100% CIQ adoption rates were compared to no adoption (0%). Non-insulin diabetes drug costs by drug class were estimated using IQVIA Longitudinal Access & Adjudication Data.
RESULTS: Model projected 85,800 PwT2D, with 21,408 on MDI. No CIQ adoption (0%) resulted in $882,115 increase in 1-Yr concomitant medication cost, corresponding to $0.88 PMPM incremental costs. With 25% CIQ adoption, the cost offset was $755,792 (86% reduction) or $0.76 PMPM savings. With 100% CIQ adoption, a cost-saving was achieved (-$1,258,938 overall or $1.26 PMPM saving).
CONCLUSIONS: CIQ adoption for PwT2D results in meaningful cost offset or savings due to decreased use of concomitant non-insulin diabetes medications, suggesting broader utilization of CIQ may optimize both clinical management and economic outcomes.