Assessing Different Procurement Models for Automated Insulin Delivery (AID) Systems Using a Multicriteria Decision Analysis (MCDA)-Based Framework
Author(s)
Jessica Yu, MSc1, Andrea Bernardini, PhD2, Elvira Mueller, MPH, PhD3, Sanja Stanisic, MSc4, Simona de Portu, PharmD, MBA1.
1Medtronic International Trading Sarl, Tolochenaz, Switzerland, 2Certara, London, United Kingdom, 3Certara, Lörrach, Germany, 4Certara, Inc, Milan, Italy.
1Medtronic International Trading Sarl, Tolochenaz, Switzerland, 2Certara, London, United Kingdom, 3Certara, Lörrach, Germany, 4Certara, Inc, Milan, Italy.
OBJECTIVES: Automated insulin delivery (AID) systems combine a continuous glucose monitor (CGM), insulin pump, and algorithm to automate insulin therapy in Type 1 Diabetes. The components of the system are often procured and reimbursed individually, despite being integrated with each other, which may conceal the holistic value of the system. A multi-criteria decision analysis (MCDA) framework was used to assess the value of an all-in-one bundle-based subscription model as an alternative to component-based procurement.
METHODS: A MCDA decision tree was developed based on frameworks that are currently being used or explored by decision-makers in Europe (EVIDEM and ADVANCE). A panel of 2 HCPs and 5 payers from Finland, Germany, Spain, and the UK ranked and scored the importance of the MCDA criteria, followed by the strength of evidence to support the bundle-based subscription model compared to traditional procurement models.
RESULTS: Five value criteria were identified to evaluate AID procurement models: innovativeness, patient benefit, impact on administrative workflow, impact on care pathway, and cost. On a scale of 0 (does not matter) to 2 (must have), the criteria patient benefit and cost received the highest mean weight of 2. These criteria were followed by impact on care pathway (1.4), innovativeness (1.3), and impact on administrative workflow (1). When shown evidence on the five criteria, there was a directional tendency to favour the bundle-based subscription model over traditional procurement models; however, stakeholders asked for larger sample sizes and local data to better inform their decisions.
CONCLUSIONS: When assessing the use of different procurement models for AID systems, stakeholders see cost and patient benefit as the most important criteria. A bundle-based subscription model may be perceived as more favourable than traditional procurement models when complemented with high-quality local evidence demonstrating improved cost control, patient benefit, care pathway, innovativeness, and administrative workflow.
METHODS: A MCDA decision tree was developed based on frameworks that are currently being used or explored by decision-makers in Europe (EVIDEM and ADVANCE). A panel of 2 HCPs and 5 payers from Finland, Germany, Spain, and the UK ranked and scored the importance of the MCDA criteria, followed by the strength of evidence to support the bundle-based subscription model compared to traditional procurement models.
RESULTS: Five value criteria were identified to evaluate AID procurement models: innovativeness, patient benefit, impact on administrative workflow, impact on care pathway, and cost. On a scale of 0 (does not matter) to 2 (must have), the criteria patient benefit and cost received the highest mean weight of 2. These criteria were followed by impact on care pathway (1.4), innovativeness (1.3), and impact on administrative workflow (1). When shown evidence on the five criteria, there was a directional tendency to favour the bundle-based subscription model over traditional procurement models; however, stakeholders asked for larger sample sizes and local data to better inform their decisions.
CONCLUSIONS: When assessing the use of different procurement models for AID systems, stakeholders see cost and patient benefit as the most important criteria. A bundle-based subscription model may be perceived as more favourable than traditional procurement models when complemented with high-quality local evidence demonstrating improved cost control, patient benefit, care pathway, innovativeness, and administrative workflow.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
MT6
Topic
Health Policy & Regulatory, Health Technology Assessment, Medical Technologies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas