ORGANIZATIONAL AND BUDGET IMPACT MODEL (OBIM) OF A NATIONAL SCREENING PROGRAM FOR PRECLINICAL TYPE 1 DIABETES (T1D) IN FRANCE
Author(s)
Roberto Mallone, MD, PhD1, Marc Nicolino, MD, PhD2, Sandrine Lablanche, MD, PhD3, Pierre Levy, PhD, MSc4, Noemie Allali, PharmD, MSc5, José Fernandes Soares, MSc6, Hélène Moutier, PharmD6, Camille Baron, PharmD, MSc5, Melissa Klein, PharmD, MSc5, Emmanuelle Blondin, PharmD, MSc5, Amar Bahloul, MD5, Anne-Lise VATAIRE, PhD, MSC5, Cécile COLLIGNON, PharmD, MSc5, Jacques Beltrand, MD, PhD7;
1Assistance Publique Hôpitaux de Paris, Service de Diabétologie et Immunologie Clinique, Cochin Hospital, Université Paris Cité, Institut Cochin, CNRS, INSERM, Paris, France, 2HCL, Lyon, France, 3CHU Grenoble, Grenoble, France, 4Médiconomie, Paris, France, 5Sanofi France, Gentilly, France, 6Rweality, Paris, France, 7Hôpital Necker, Paris, France
1Assistance Publique Hôpitaux de Paris, Service de Diabétologie et Immunologie Clinique, Cochin Hospital, Université Paris Cité, Institut Cochin, CNRS, INSERM, Paris, France, 2HCL, Lyon, France, 3CHU Grenoble, Grenoble, France, 4Médiconomie, Paris, France, 5Sanofi France, Gentilly, France, 6Rweality, Paris, France, 7Hôpital Necker, Paris, France
OBJECTIVES: Recent French expert position paper recommended systematic screening and structured follow-up of early-stage type 1 diabetes (T1D), primarily among first-degree relatives (FDRs) of T1D patients, who are at highest risk (Mallone et al., 2024). Implementing a national preclinical T1D screening program would have multiple implications for the French healthcare system. These impacts are multidimensional, affecting diagnostic capacity, medical resources, logistics, and overall costs depending on the perspective (collective, payer, societal). We propose a structured OBIM (organizational and budget impact model) to inform this national preclinical T1D screening program. Our objectives were to: (i) model plausible screening pathways in collaboration with French experts in T1D; and (ii) compare their economic and organizational impacts with the current situation without systematic population screening.
METHODS: Various plausible preclinical T1D screening pathways were mapped based on French expert recommendations and consultations to characterize patient management, screening modalities, and healthcare resource use and to define the structure and main assumptions in the model, in line with the specificities of the French healthcare system.
RESULTS: Several preclinical T1D screening pathways were modelled mainly depending on the target population (FDRs, general paediatric or high-risk populations), number of screening rounds, and type of sampling strategy (venous/capillary) or the screening sites (e.g., expert centers, city-practice physicians, community laboratories and self-sampling at home). Screening options also differ in test types (simplified multiplex autoantibody vs. individual autoantibody tests) likewise follow-up procedures (HbA1c, OGTT, fasting glucose, CGM). Several plausible pathways were implemented in an Excel-based OBIM to compare costs and organizational differences between a nationwide screening program and the current situation without systematic screening for T1D.
CONCLUSIONS: We report the first comprehensive OBIM model for France, encompassing different populations and screening pathways: we believe it could help stakeholders implement systematic preclinical T1D screening programs at local or national levels.
METHODS: Various plausible preclinical T1D screening pathways were mapped based on French expert recommendations and consultations to characterize patient management, screening modalities, and healthcare resource use and to define the structure and main assumptions in the model, in line with the specificities of the French healthcare system.
RESULTS: Several preclinical T1D screening pathways were modelled mainly depending on the target population (FDRs, general paediatric or high-risk populations), number of screening rounds, and type of sampling strategy (venous/capillary) or the screening sites (e.g., expert centers, city-practice physicians, community laboratories and self-sampling at home). Screening options also differ in test types (simplified multiplex autoantibody vs. individual autoantibody tests) likewise follow-up procedures (HbA1c, OGTT, fasting glucose, CGM). Several plausible pathways were implemented in an Excel-based OBIM to compare costs and organizational differences between a nationwide screening program and the current situation without systematic screening for T1D.
CONCLUSIONS: We report the first comprehensive OBIM model for France, encompassing different populations and screening pathways: we believe it could help stakeholders implement systematic preclinical T1D screening programs at local or national levels.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE225
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)