HEALTH-ECONOMIC COMPARISON OF SENSOR-AUGMENTED PUMP WITH LOW GLUCOSE SUSPEND VERSUS INSULIN PUMP ALONE FOR THE TREATMENT OF HYPO-PRONE TYPE 1 DIABETES IN HUNGARY
Author(s)
Roze S1, Lynch P2, Boncz I3, Dunne N2, Varga C4, Klots M2, Karamalis M2, Felszeghy E5
1HEVA HEOR, Lyon, France, 2Medtronic, Tolochenaz, Switzerland, 3Faculty of Health Sciences, University of Pécs, Pécs, Hungary, 4Medtronic Hungary, Budapest, Hungary, 5University of Debrecen, Medical School and Health Science Centre, Pediatric Dept., Debrecen, Hungary
OBJECTIVES: To project the long-term costs and outcomes of sensor-augmented pump (SAP) with low glucose suspend (LGS) versus insulin pump (CSII) alone for the treatment of hypo-prone Type 1 diabetes in Hungary. METHODS: The CORE Diabetes Model is a peer-reviewed, validated model, which employs standard Markov/Monte Carlo simulation techniques to describe the long-term incidence and progression of diabetes-related complications. It was used to simulate disease progression in a cohort of patients with baseline characteristics (mean age 18.6 years, duration of diabetes 12 years, mean HbA1c 7.5%) and clinical outcomes (severe hypoglycaemic event rates; Quality of Life; HbA1c) taken from a recent randomised controlled trial (Ly et al, 2013). Local treatment and complication cost data was used. The main scenario considered in this cost-effectiveness analysis was the comparison of sensor-augmented insulin pump (SAP) with low glucose suspend (LGS) versus pump alone (CSII). The target population was hypo-prone type I diabetes patients with the analysis based on a deterministic microsimulation of 1,000 patients, using a 1 to 5 year time horizon. Direct costs were calculated from a third-party payer perspective. Discount rates of 3.7% per annum were applied to both costs and clinical outcomes. RESULTS: The Incremental-Cost-Effectiveness-Ratio (ICER) for SAP+LGS vs CSII was HUF 6,196,086 (€20,298) per Quality-Adjusted-Life-Year gained over a 1 year time horizon. Results were similar using a 5 year time horizon (HUF 6,125,823 [€20,068] per QALY gained). Extensive sensitivity analyses showed the robustness of the results. CONCLUSIONS: Using a payer’s perspective, our analysis showed that SAP (w LGS) is cost-effective over a short term (1-5 year) time horizon in hypo prone patients with Type 1 Diabetes in Hungary (using a WTP threshold of 3x Hungary GDP).
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PDB72
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Diabetes/Endocrine/Metabolic Disorders