OBJECTIVES: Improved glycemic control, measured by HbA1c, is associated with reduced diabetes-related complication risks. The Advanced Hybrid Closed Loop (AHCL) system with automated adjustment of insulin delivery and correction bolus features, improves glycemic outcomes for people with type 1 diabetes with suboptimal glycemic control compared to the standard of care, which is multiple daily insulin injections with intermittently scanned continuous glucose monitoring (MDI+isCGM). The aim of this study is to assess potential short-term cost savings of using AHCL vs MDI+isCGM in Europe.

METHODS: A previously published budget impact model with a 5-year time horizon was used (Choudhary P. et al. Diabet Med. 2019;36(8):988-994). The cost savings modelled through 5 years were converted into average per patient per year savings. Countries in scope were Austria, Germany, Greece, France, the Netherlands, Italy and Spain. Complications costs and work absenteeism data were derived from published literature and tariffs. Baseline and change in HbA1c were sourced from a 6-month randomized controlled trial (Choudhary P. et al. Lancet Diabetes Endocrinol. 2022;10(10):720-731.).

RESULTS: With AHCL use, HbA1c decreased from 9% to 7.4%. The direct cost savings (complications only) varied between 390€-556€ per patient per year, while the total cost savings (complications and productivity) varied between 624€-805€ per patient per year, depending on the country. These results corresponded to an average direct cost savings of 486€ per patient per year and to an average total cost savings of 712€ per patient per year in Europe, through the first 5 years of therapy initiation.

CONCLUSIONS: The improved glycemic control with AHCL can be translated into potential cost savings thanks to reduced complications cost and improved productivity. Therefore, higher AHCL therapy implementation costs can be partially offset versus MDI+isCGM, even in a 5-year time horizon. These findings complement the longer-term cost-effectiveness results of AHCL, suggesting it also offers good short-term value for money.