Cost-Effectiveness of Control-IQ Hybrid Closed-Loop System in Adults With Type 1 Diabetes in Sweden
Author(s)
Nuno Picado, PhD1, Maaike Janssen, MSc.2, Rico Lepzien, PhD2, Francesca Fiorentino, PhD3, Sharon M Wang, PharmD, MSc4, Bimal V Patel, PharmD, MSc4, Charlotte Ekelund, MD, PhD5.
1IQVIA Portugal, Oeiras, Portugal, 2IQVIA Nordics, Stockholm, Sweden, 3IQVIA Italy, Milan, Italy, 4Tandem Diabetes Care, San Diego, CA, USA, 5Rubin Medical, Malmo, Sweden.
1IQVIA Portugal, Oeiras, Portugal, 2IQVIA Nordics, Stockholm, Sweden, 3IQVIA Italy, Milan, Italy, 4Tandem Diabetes Care, San Diego, CA, USA, 5Rubin Medical, Malmo, Sweden.
OBJECTIVES: This study assesses the long-term cost-effectiveness of the Control-IQ technology, a hybrid closed-loop (HCL) insulin delivery system, compared to standard care—defined as a real-world mix of multiple daily injections (MDI) and insulin pump therapy with continuous glucose monitoring (CGM)—in adults with type 1 diabetes (T1D), from the payer perspective in Sweden.
METHODS: A lifetime cost-effectiveness analysis was conducted using the IQVIA Core Diabetes Model (CDM). The base case population included adults with T1D, with baseline characteristics and treatment effects based on a Belgian real-world study (RWS) with 12-month follow-up. Clinical inputs included changes in HbA1c and time in range (TIR) from the RWS. Direct medical costs included treatment, complication management, and severe hypoglycemia treatment. Country-specific cost inputs were informed by a targeted literature review and validated by local stakeholders. Utilities were sourced from published literature and considered a reduction in fear of hypoglycemia (FOH) associated with Control-IQ in line with data collected in iDCL clinical trial. Scenario analyses explored variations in discount rates, time horizon, indirect costs, and alternative efficacy sources, including the iDCL trial. Outcomes included life years (LYs), quality-adjusted life years (QALYs), total costs, and incremental cost-effectiveness ratios (ICERs/ICURs).
RESULTS: In Sweden, Control-IQ yielded 15.39 QALYs versus 14.34 for standard care, with total costs of 2,200,198 SEK and 1,775,801 SEK, respectively, leading to an ICUR of 404,612 SEK/QALY (~€35,184/QALY). In terms of adverse events, the implementation of Control-IQ technology was associated with a lifetime reduction of 4.82 cases of severe hypoglycemia per patient. Scenario analyses confirmed robustness across assumptions.
CONCLUSIONS: Control-IQ technology improves clinical outcomes and reduces complication-related costs in adults with T1D. Despite higher upfront treatment costs, it is cost-effective in Sweden. The ICUR fall below commonly cited willingness-to-pay thresholds (500,000 SEK/QALY), supporting reimbursement and adoption.
METHODS: A lifetime cost-effectiveness analysis was conducted using the IQVIA Core Diabetes Model (CDM). The base case population included adults with T1D, with baseline characteristics and treatment effects based on a Belgian real-world study (RWS) with 12-month follow-up. Clinical inputs included changes in HbA1c and time in range (TIR) from the RWS. Direct medical costs included treatment, complication management, and severe hypoglycemia treatment. Country-specific cost inputs were informed by a targeted literature review and validated by local stakeholders. Utilities were sourced from published literature and considered a reduction in fear of hypoglycemia (FOH) associated with Control-IQ in line with data collected in iDCL clinical trial. Scenario analyses explored variations in discount rates, time horizon, indirect costs, and alternative efficacy sources, including the iDCL trial. Outcomes included life years (LYs), quality-adjusted life years (QALYs), total costs, and incremental cost-effectiveness ratios (ICERs/ICURs).
RESULTS: In Sweden, Control-IQ yielded 15.39 QALYs versus 14.34 for standard care, with total costs of 2,200,198 SEK and 1,775,801 SEK, respectively, leading to an ICUR of 404,612 SEK/QALY (~€35,184/QALY). In terms of adverse events, the implementation of Control-IQ technology was associated with a lifetime reduction of 4.82 cases of severe hypoglycemia per patient. Scenario analyses confirmed robustness across assumptions.
CONCLUSIONS: Control-IQ technology improves clinical outcomes and reduces complication-related costs in adults with T1D. Despite higher upfront treatment costs, it is cost-effective in Sweden. The ICUR fall below commonly cited willingness-to-pay thresholds (500,000 SEK/QALY), supporting reimbursement and adoption.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE243
Topic
Clinical Outcomes, Economic Evaluation, Medical Technologies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)