OBJECTIVES : To estimate the clinical and economic impact of Sensor augmented pump (SAP) in type 1 Diabetes Mellitus patients in Colombia.

METHODS : The Core Diabetes Model v9.5 (CDM) is a highly validated, computer simulation model that determines the long-term health outcomes and economic consequences of diabetes interventions. The baseline characteristics of the simulated cohorts were obtained from a Colombian clinical study evaluating T1DM patients. Results of the study showed that SAP therapy led to a reduction of -1.67 % HbA1c with significant reduction in severe hypoglycemic events. In the base case, the direct costs of the complications and treatment were estimated in US dollars from a third payer perspective. No indirect costs were analyzed. The model used a 60-year time horizon, and a discount rate of 5% was applied for health outcomes and costs. Default CDM utility measures were applied to estimate Quality Adjusted Life Years (QALY´s). No subgroups were analyzed in the simulation.

RESULTS : The simulation showed a 3,037 QALY gain with SAP and an ICER of $17,250 per QALY. The life expectancy with SAP increased by 0,418 years and diabetes related complications were delayed on average by 5,35 years. SAP related therapy costs were offset by savings due to the reduction in long-term complications. The relative reduction incidence of complications was (Proliferative diabetic retinopathy 23,63%, Severe vision loss 14,78%, End stage renal disease 0,32%, Amputation 0,29%) as well as an average delay of onset was (7,1 years, 4,69 years, 2,22 years, 1,86 years, respectively) with SAP therapy. Sensitivity analyses corroborated the robustness of the results.

CONCLUSIONS : The analysis showed that SAP is cost-effective over a 60-year time horizon in DMT1 patients in the Colombian from a third payer perspective considering a WTP threshold of $ 19,926 USD (3x GDP) and can lead to an increase in life expectancy and Quality of Life