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首页> 外文期刊>Diabetes therapy >Cost-Effectiveness Analysis of Sensor-Augmented Insulin Pump Therapy with Automated Insulin Suspension Versus Standard Insulin Pump Therapy in Patients with Type 1 Diabetes in Sweden
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Cost-Effectiveness Analysis of Sensor-Augmented Insulin Pump Therapy with Automated Insulin Suspension Versus Standard Insulin Pump Therapy in Patients with Type 1 Diabetes in Sweden

机译：在瑞典1型糖尿病患者中，采用传感器增强型胰岛素泵自动悬吊治疗与标准胰岛素泵治疗相比的成本效果分析

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IntroductionIn Sweden an estimated 10,000 people with type 1 diabetes use continuous subcutaneous insulin infusion (CSII). Sensor-augmented pump therapy (SAP) is associated with higher acquisition costs but provides additional clinical benefits (e.g. reduced rate of hypoglycemic events) over and above that of CSII alone. The aim of the analysis was to assess the cost-effectiveness of SAP with automated insulin suspension relative to CSII alone in two different groups of patients with type 1 diabetes in Sweden. MethodsCost-effectiveness analyses were performed using the QuintilesIMS CORE Diabetes Model, with clinical and economic input data derived from published literature. Separate analyses were performed for patients at increased risk of hypoglycemia and for patients with uncontrolled glycated hemoglobin (HbA1c) at baseline. Analyses were performed from a societal perspective over a lifetime time horizon. Future costs and clinical outcomes were discounted at 3% per annum. ResultsSAP with automated insulin suspension was associated with an incremental gain in quality-adjusted life expectancy versus the CSII of 1.88 quality-adjusted life years (QALYs) in patients at high risk of hypoglycemia and of 1.07 QALYs in patients with uncontrolled HbA1c at baseline. Higher lifetime costs for SAP with automated insulin suspension resulted in projected incremental cost-effectiveness ratios for the SAP with automated insulin suspension versus CSII of Swedish Krona (SEK)?139,795 [euros (EUR)?14,648] per QALY gained for patients at increased risk for hypoglycemia and SEK?251,896 (EUR?26,395) per QALY gained for patients with uncontrolled HbA1c. In both groups, SAP with automated insulin suspension also reduced the incidence of diabetes-related complications relative to CSII. ConclusionsIn Sweden, SAP with automated insulin suspension likely represents a cost-effective treatment option relative to CSII for the management of patients with type 1 diabetes with a history of severe hypoglycemic events or patients who struggle to achieve good glycemic control despite the use of CSII. FundingMedtronic International Trading Sàrl.
机译：简介在瑞典，估计有10,000名1型糖尿病患者使用连续皮下胰岛素输注（CSII）。传感器增强泵治疗（SAP）与更高的获取成本相关联，但与单独的CSII相比，具有更多的临床益处（例如，降血糖事件的发生率降低）。该分析的目的是评估在瑞典的两组不同的1型糖尿病患者中，相对于CSII而言，采用自动胰岛素悬浮液治疗SAP的成本效益。方法使用QuintilesIMS CORE糖尿病模型进行成本效益分析，并从已发表的文献中获得临床和经济输入数据。对基线时低血糖风险增加的患者和糖化血红蛋白（HbA1c）不受控制的患者进行了单独分析。从社会角度对一生的时间范围进行了分析。未来成本和临床结局每年折现3％。结果具有自动胰岛素悬液的SAP与低血糖高危患者的CSII的质量调整寿命相比增加了1.88质量调整的生命年（QALYs），基线时不受控制的HbA1c患者的CSII增加了1.07 QALYs。带有自动胰岛素悬浮液的SAP的终生成本较高，导致相对于风险增加的患者，每QALY相对于瑞典克朗（SEK）的CSII（SEK）139,795 [euros（EUR）？14,648]的CSII的预期成本效益比提高了对于低血糖患者，HbA1c不受控制的患者每QALY可获得251,896瑞典克朗（26,395欧元）。在两组中，相对于CSII而言，具有自动胰岛素悬浮液的SAP均可降低糖尿病相关并发症的发生率。结论在瑞典，相对于CSII而言，具有自动降糖功能的SAP可能代表具有重度低血糖事件史的1型糖尿病患者或尽管使用CSII仍难以实现良好血糖控制的患者，但相对于CSII而言，这可能是一种经济高效的治疗选择。资金美敦力国际贸易公司。

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