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Endocrinol Nutr. 2016 Nov;63(9):466-474. doi: 10.1016/j.endonu.2016.05.011. Epub 2016 Aug 30.

Clinical and economic benefits of integrated pump/CGM technology therapy in patients with type 1 diabetes in Colombia.

[Article in English, Spanish]

Author information

1
Hospital Universitario de San Ignacio-Universidad Javeriana, Bogotá, Colombia. Electronic address: amgomezm5@gmail.com.
2
University of Washington, Seattle, WA, EE. UU.; RANDOM Foundation, Bogotá, Colombia.
3
Medtronic PLC Andean Region, Bogotá, Colombia.
4
Medtronic Diabetes Inc., Northridge, CA, EE. UU.
5
University of Washington, Seattle, WA, EE. UU.
6
Ossian Health Economics and Communications, Basilea, Suiza.
7
HEVA HEOR, Lyon, Francia.
8
Medtronic Latinamerica Inc., Miami, FL, EE. UU.

Abstract

OBJECTIVE:

To assess the long-term clinical and economic impact of integrated pump/CGM technology therapy as compared to multiple daily injections (MDI), for the treatment of type 1 diabetes (T1D) in Colombia.

METHODS:

The CORE Diabetes Model was used to simulate a hypothetical cohort of patients with T1D. Mean baseline characteristics were taken from a clinical study conducted in Colombia and a healthcare payer perspective was adopted, with a 5% annual discount rate applied to both costs and outcomes.

RESULTS:

The integrated pump/CGM improved mean life expectancy by 3.51 years compared with MDI. A similar increase occurred in mean quality-adjusted life expectancy with an additional 3.81 quality-adjusted life years (QALYs). Onset of diabetes-related complications was also delayed as compared to MDI, and mean survival time free of complication increased by 1.74 years with integrated pump/CGM. Although this increased treatment costs of diabetes as compared to MDI, savings were achieved thanks to reduced expenditure on diabetes-related complications. The estimated incremental cost-effectiveness ratio (ICER) for SAP was Colombian Pesos (COP) 44,893,950 (approximately USD$23,200) per QALY gained.

CONCLUSIONS:

Improved blood glucose control associated to integrated pump/CGM results in a decreased incidence of diabetes-related complications and improves life expectancy as compared to MDI. Using recommended thresholds from the World Health Organization and previous coverage decisions about health technologies in Colombia, it is a cost-effective alternative to MDI for the treatment of type 1 diabetes in Colombia.

KEYWORDS:

Análisis de coste-efectividad; Continuous glucose monitoring; Cost-effectiveness analysis; Decision modeling; Diabetes tipo 1; Insulin infusion systems; Modelamiento de decisiones.; Monitorización continua de glucosa; Sistemas de infusión de insulina; Type 1 diabetes

PMID:
27595241
DOI:
10.1016/j.endonu.2016.05.011
[Indexed for MEDLINE]

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