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Curr Diab Rep. 2019 Aug 2;19(9):75. doi: 10.1007/s11892-019-1203-9.

Economics of Beta-Cell Replacement Therapy.

Author information

1
Department of Bioengineering and iBB - Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
2
The Discoveries Center for Regenerative and Precision Medicine, Lisbon Campus, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
3
Division of Clinical Informatics, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
4
Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
5
Institute for Data, Systems and Society, Massachusetts Institute of Technology, Cambridge, MA, USA.
6
Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA. Robert.Gabbay@joslin.harvard.edu.

Abstract

PURPOSE OF REVIEW:

Type 1 diabetes impacts 1.3 million people in the USA with a total direct lifetime medical cost of $133.7 billion. Management requires a mix of daily exogenous insulin administration and frequent glucose monitoring. Decision-making by the individual can be burdensome.

RECENT FINDINGS:

Beta-cell replacement, which involves devices protecting cells from autoimmunity and allo-rejection, aims at restoring physiological glucose regulation and improving clinical outcomes in patients. Given the significant burden of T1D in the healthcare systems, cost-effectiveness analyses can drive innovation and policymaking in the area. This review presents the health economics analyses performed for donor-derived islet transplantation and the possible outcomes of stem cell-derived beta cells. Long-term cost-effectiveness of islet transplantation depends on the engraftment of these transplants, and the expenses and thresholds assumed by healthcare systems in different countries. Early health technology assessment analyses for stem cell-derived beta-cell replacement suggest manufacturing optimization is necessary to reduce upfront costs.

KEYWORDS:

Cost-effectiveness; Early health technology assessment; Islet transplant; Stem cells; Type 1 diabetes

PMID:
31375935
DOI:
10.1007/s11892-019-1203-9

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