ECONOMIC AND ORGANIZATIONAL IMPACT OF PRECLINICAL TYPE 1 DIABETES SCREENING IN FRANCE: RESULTS FROM AN ORGANIZATIONAL AND BUDGET IMPACT MODEL
Author(s)
Roberto Mallone, MD, PhD1, Marc Nicolino, MD, PhD2, Sandrine Lablanche, MD, PhD3, Stephanie Haim-Boukobza, Pharma D, PhD4, Laurence Pellegrina, PharmD, MSc5, Pierre Levy, PhD6, Noemie Allali, PharmD, MSc7, Nathalie Grémaud, PharmD, MSc8, José Fernandes Soares, MSc8, Camille Baron, PharmD, MSc7, Jacques Beltrand, MD, PhD9.
1Assistance Publique Hôpitaux de Paris, Service de Diabétologie et Immunologie Clinique, Hôpital Cochin, Université Paris Cité, Institut Cochin, CNRS, INSERM, Paris, France, 2HCL, Lyon, France, 3Université, Grenoble Alpes, Service de Diabétologie, Endocrinologie, Nutrition, CHU Grenoble Alpes, Grenoble, France, 4CERBA Healthcare, Issy-les-Moulineaux, France, 5Eurofins Biomnis, Lyon, France, 6Médiconomie, Paris, France, 7Sanofi, Gentilly, France, 8Rweality, Paris, France, 9Service d’endocrinologie, gynécologie et diabétologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, Université Paris Cité, Paris, France.
1Assistance Publique Hôpitaux de Paris, Service de Diabétologie et Immunologie Clinique, Hôpital Cochin, Université Paris Cité, Institut Cochin, CNRS, INSERM, Paris, France, 2HCL, Lyon, France, 3Université, Grenoble Alpes, Service de Diabétologie, Endocrinologie, Nutrition, CHU Grenoble Alpes, Grenoble, France, 4CERBA Healthcare, Issy-les-Moulineaux, France, 5Eurofins Biomnis, Lyon, France, 6Médiconomie, Paris, France, 7Sanofi, Gentilly, France, 8Rweality, Paris, France, 9Service d’endocrinologie, gynécologie et diabétologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, Université Paris Cité, Paris, France.
OBJECTIVES: Implementing nationwide screening for preclinical type 1 diabetes (T1D) would have implications for the healthcare system, affecting resource utilization, diagnostic capacity, logistics and societal perspectives. An Organizational and Budget Impact Model (OBIM), developed with French clinical, laboratory, and health economic experts, assessed the economic and organizational impact of screening strategies[i] compared with current practice without systematic screening.
METHODS: Two populations were evaluated: first-degree relatives (FDRs) of individuals with T1D and the general pediatric population. For FDRs, models included 169,694 prevalent and 4,628 incident T1D cases[ii] , 2.56 FDRs per index case (434,417 prevalent eligible individuals and 11,848 newly eligible annually), 3.6% annual incidence growth, up to three screening rounds (ages 2-4, 6-9, 10-12 years), participation rates of 50% (minors) and 25% (adults), and confirmatory testing for individuals with ≥1 positive autoantibody. Pediatric screening assumptions were based on a French scientific committee. Outcomes included annual budget impact, cost per screened and positive individual, healthcare resource use, travel burden, productivity losses, and CO₂ emissions.
RESULTS: Across FDR screening scenarios, the mean annual budget impact ranged from €2.0 to €2.5 million including prevalent and incident cases. On average, 591 T1D cases were identified annually. Results for general pediatric population screening scenarios will also be presented. In both populations, the autoantibody analytical method was the main cost driver, while organizational choices mainly affected resource use, workload distribution, travel distance, and productivity losses.
CONCLUSIONS: This analysis quantifies the economic and organizational consequences of implementing organized T1D screening in France. Beyond budget impact, pathway design strongly influences healthcare resource utilization and organization, while having limited impact on cost per detected case. These findings support selection of feasible and efficient screening strategies.
[i] ISPOR US 2026, EE225[ii] ISPOR Eu Sanofi-DT1-Poster-ISPOR2025-V3-WEB
METHODS: Two populations were evaluated: first-degree relatives (FDRs) of individuals with T1D and the general pediatric population. For FDRs, models included 169,694 prevalent and 4,628 incident T1D cases[ii] , 2.56 FDRs per index case (434,417 prevalent eligible individuals and 11,848 newly eligible annually), 3.6% annual incidence growth, up to three screening rounds (ages 2-4, 6-9, 10-12 years), participation rates of 50% (minors) and 25% (adults), and confirmatory testing for individuals with ≥1 positive autoantibody. Pediatric screening assumptions were based on a French scientific committee. Outcomes included annual budget impact, cost per screened and positive individual, healthcare resource use, travel burden, productivity losses, and CO₂ emissions.
RESULTS: Across FDR screening scenarios, the mean annual budget impact ranged from €2.0 to €2.5 million including prevalent and incident cases. On average, 591 T1D cases were identified annually. Results for general pediatric population screening scenarios will also be presented. In both populations, the autoantibody analytical method was the main cost driver, while organizational choices mainly affected resource use, workload distribution, travel distance, and productivity losses.
CONCLUSIONS: This analysis quantifies the economic and organizational consequences of implementing organized T1D screening in France. Beyond budget impact, pathway design strongly influences healthcare resource utilization and organization, while having limited impact on cost per detected case. These findings support selection of feasible and efficient screening strategies.
[i] ISPOR US 2026, EE225[ii] ISPOR Eu Sanofi-DT1-Poster-ISPOR2025-V3-WEB
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE481
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Budget Impact Analysis
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas