The VIS1ON Horizon Scanning Model: Predicting the Evolution of Direct NHS Expenditure for Type 1 Diabetes in Italy up to 2028
Author(s)
Federico Boscari, Dr1, Stefano Passanisi, Dr2, Basilio Pintaudi, Dr3, Rocky Strollo, Prof4, Andrea Marcellusi, PhD5, Massimo Riccaboni, Prof6, Anita Ciarlo, MD7, Paola La Malfa, MD7, Alessia Tettamanti, MD7, Amedeo Principe, MD8, GIANLUCA AGOSTONI, MD8, Clara Trimarchi, MD8.
1University Hospital of Padua, Padua, Italy, 2University of Messina, Messina, Italy, 3Niguarda Hospital, Milan, Italy, 4San Raffaele Open University of Rome, Rome, Italy, 5University of Milan, Milan, Italy, 6IMT School for Advanced Studies, Lucca, Italy, 7IQVIA, Milan, Italy, 8Sanofi, Milan, Italy.
1University Hospital of Padua, Padua, Italy, 2University of Messina, Messina, Italy, 3Niguarda Hospital, Milan, Italy, 4San Raffaele Open University of Rome, Rome, Italy, 5University of Milan, Milan, Italy, 6IMT School for Advanced Studies, Lucca, Italy, 7IQVIA, Milan, Italy, 8Sanofi, Milan, Italy.
Presentation Documents
OBJECTIVES: The management of type 1 diabetes (T1D) in Italy is undergoing a significant transformation due to the current and future availability of screening for presymptomatic disease, disease-modifying therapies (DMTs) and high-technology medical devices (MDs). This study estimates the current and future direct T1D pharmaceutical and devices expenditure by the Italian National Health Service (NHS).
METHODS: A static cost-calculator model was developed to simulate NHS expenditure over 2021-2028. Data from 2021-2023 defined the model baseline, while projections from 2024 onward were based on historical trends and anticipated market developments, real-world data, literature and publicly available sources. The model included costs of insulin, DMTs, continuous glucose monitoring (CGM), insulin pumps, and T1D screening. Model inputs and assumptions were validated with clinical and economical experts and deterministic sensitivity analyses were conducted to test results’ robustness.
RESULTS: Total T1D expenditure is predicted to increase with a compound annual growth rate (CAGR) of +4.9%, reaching around € 890 million in 2028. The increase in the number of registered T1D cases (+0.15%) is only a milder driver of expenditure increase, which is primarily driven by a wider use of MDs, representing the highest-expenditure category (€797 million in 2028, +6.07% CAGR). Conversely, pharmaceutical expenditure is expected to decrease (€91 million in 2028, CAGR: -2.4%), also considering the introduction of teplizumab, the only DMT foreseen to be reimbursed by 2028. Its impact on total expenditure is indeed projected to be contained and partially offset by the progressive decline in insulin costs, due to tendering dynamics and price renegotiation, as well as by savings resulting from deferred MDs utilization due to delayed disease onset.
CONCLUSIONS: This original analysis of direct NHS expenditure for T1D in Italy offers insights for decision-makers in planning and preparing the NHS for the upcoming therapeutic and technological innovations.
METHODS: A static cost-calculator model was developed to simulate NHS expenditure over 2021-2028. Data from 2021-2023 defined the model baseline, while projections from 2024 onward were based on historical trends and anticipated market developments, real-world data, literature and publicly available sources. The model included costs of insulin, DMTs, continuous glucose monitoring (CGM), insulin pumps, and T1D screening. Model inputs and assumptions were validated with clinical and economical experts and deterministic sensitivity analyses were conducted to test results’ robustness.
RESULTS: Total T1D expenditure is predicted to increase with a compound annual growth rate (CAGR) of +4.9%, reaching around € 890 million in 2028. The increase in the number of registered T1D cases (+0.15%) is only a milder driver of expenditure increase, which is primarily driven by a wider use of MDs, representing the highest-expenditure category (€797 million in 2028, +6.07% CAGR). Conversely, pharmaceutical expenditure is expected to decrease (€91 million in 2028, CAGR: -2.4%), also considering the introduction of teplizumab, the only DMT foreseen to be reimbursed by 2028. Its impact on total expenditure is indeed projected to be contained and partially offset by the progressive decline in insulin costs, due to tendering dynamics and price renegotiation, as well as by savings resulting from deferred MDs utilization due to delayed disease onset.
CONCLUSIONS: This original analysis of direct NHS expenditure for T1D in Italy offers insights for decision-makers in planning and preparing the NHS for the upcoming therapeutic and technological innovations.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE728
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), Pediatrics