DEVELOPMENT OF A COST UTILITY MODEL TO ASSESS THE INCREMENTAL COST EFFECTIVENESS OF CONTINUOUS DUAL GLUCOSE KETONE MONITORING SYSTEM VERSUS CONTINUOUS GLUCOSE MONITORING SYSTEM IN PEOPLE WITH DIABETES
Author(s)
Johan Jendle, MD, PhD1, Mark Moses2, Kirk Szafranski, MSc3, Donghyun Lee, PhD3, Tiegh Taylor, PhD3, Fleur Levrat Guillen, PharmD4;
1Institution of Medical Sciences, Örebro, Sweden, 2Abbott, Manager, alameda, CA, USA, 3EVERSANA, Stoney Creek, ON, Canada, 4Abbott diabetes care, London, United Kingdom
1Institution of Medical Sciences, Örebro, Sweden, 2Abbott, Manager, alameda, CA, USA, 3EVERSANA, Stoney Creek, ON, Canada, 4Abbott diabetes care, London, United Kingdom
OBJECTIVES: Diabetic ketoacidosis (DKA) is a major concern globally for people with insulin-treated diabetes. Novel dual glucose ketone continuous monitoring systems (DGKs) are being developed and are expected to reduce DKA. Prior methodologies to assess the cost utility of continuous glucose monitors (CGMs) vs self-monitoring of blood glucose may be overly complex to compare DGKs vs CGMs given that no difference in glycated hemoglobin is anticipated. Therefore, a new structure is needed.
METHODS: A Markov model was developed with yearly cycles and three health states: diabetes with no DKA, diabetes with DKA (one cycle tunnel state), and death (any cause). In absence of pending trial results assessing DGKs, the model tested multiple transition probabilities from no DKA to DKA. Transition from any health state to death was based on general population mortality with a diabetes standardized mortality ratio and mortality due to DKA. Utilities were modeled for general diabetes utility, a disutility for DKA occurrence, and a treatment benefit utility for DGKs from an ongoing time trade-off study in the United Kingdom (UK).
RESULTS: The model predicted that a reduction in DKA would result in incremental quality-adjusted life-years (QALYs). Results of a UK parameterized analysis for both T1D and T2D showed that DGKs would be cost effective versus CGMs under a range of assumptions for incremental cost and DKA-related treatment benefit. Using a willingness-to-pay threshold in the UK of £35,000/QALY, DGKs would be cost effective even at a 50% price premium, assuming a 0.01 treatment benefit and a 20% reduction in DKA events.
CONCLUSIONS: A simpler Markov model structure is proposed to assess the cost-effectiveness of DGKs vs CGMs. Simulations demonstrate that DGKs may be cost effective across a variety of scenarios.
METHODS: A Markov model was developed with yearly cycles and three health states: diabetes with no DKA, diabetes with DKA (one cycle tunnel state), and death (any cause). In absence of pending trial results assessing DGKs, the model tested multiple transition probabilities from no DKA to DKA. Transition from any health state to death was based on general population mortality with a diabetes standardized mortality ratio and mortality due to DKA. Utilities were modeled for general diabetes utility, a disutility for DKA occurrence, and a treatment benefit utility for DGKs from an ongoing time trade-off study in the United Kingdom (UK).
RESULTS: The model predicted that a reduction in DKA would result in incremental quality-adjusted life-years (QALYs). Results of a UK parameterized analysis for both T1D and T2D showed that DGKs would be cost effective versus CGMs under a range of assumptions for incremental cost and DKA-related treatment benefit. Using a willingness-to-pay threshold in the UK of £35,000/QALY, DGKs would be cost effective even at a 50% price premium, assuming a 0.01 treatment benefit and a 20% reduction in DKA events.
CONCLUSIONS: A simpler Markov model structure is proposed to assess the cost-effectiveness of DGKs vs CGMs. Simulations demonstrate that DGKs may be cost effective across a variety of scenarios.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE434
Topic
Economic Evaluation
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)