Smart Insulin Pens are Associated with Improved Clinical Outcomes at Lower Cost Versus Standard-of-Care Treatment of Typ
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ORIGINAL RESEARCH
Smart Insulin Pens are Associated with Improved Clinical Outcomes at Lower Cost Versus Standard-ofCare Treatment of Type 1 Diabetes in Sweden: A Cost-Effectiveness Analysis Johan Jendle
. A˚sa Ericsson . Jens Gundgaard . Jonas Bech Møller .
William J. Valentine . Barnaby Hunt
Received: October 12, 2020 / Accepted: November 28, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Real-world evidence has demonstrated improved glycemic control and insulin management following introduction of smart insulin pens in a Swedish type 1 diabetes (T1D) population. To understand the implications for healthcare costs and expected health outcomes, this analysis evaluated the long-term cost-effectiveness of introducing smart insulin pens to standard-of-care T1D treatment (standard care) from a Swedish societal perspective. Methods: Clinical outcomes and healthcare costs (in 2018 Swedish krona, SEK) were projected over patients’ lifetimes using the IQVIA CORE Diabetes Model to estimate cost-effectiveness. Clinical data and baseline Supplementary Information The online version contains supplementary material available at https:// doi.org/10.1007/s13300-020-00980-1. J. Jendle (&) ¨ rebro University, Institute of Medical Sciences, O ¨ rebro, Sweden O e-mail: [email protected] ˚ . Ericsson A ¨ , Sweden Novo Nordisk Scandinavia AB, Malmo J. Gundgaard J. B. Møller Novo Nordisk A/S, Søborg, Denmark W. J. Valentine B. Hunt Ossian Health Economics and Communications, Basel, Switzerland
characteristics for the simulated cohort were informed by population data and a prospective, noninterventional study of a smart insulin pen in a Swedish T1D population. This analysis captured direct and indirect costs, mortality, and the impact of diabetes-related complications on quality of life. Results: Over patients’ lifetimes, smart insulin pen use was associated with per-patient improvements in mean discounted life expectancy (? 0.90 years) and quality-adjusted life expectancy (? 1.15 quality-adjusted life-years), in addition to mean cost savings (direct, SEK 124,270; indirect, SEK 373,725), versus standard care. A lower frequency and delayed onset of complications drove projected improvements in quality-adjusted life expectancy and lower costs with smart insulin pens versus standard care. Overall, smart insulin pens were a dominant treatment option relative to standard care across all base-case and sensitivity analyses. Conclusions: Use of smart insulin pens was projected to improve clinical outcomes at lower costs relative to standard care in a Swedish T1D population and represents a good use of healthcare resources in Sweden. Keywords: Diabetes complications; Diabetes self-management; Diabetes technology; Digital health; eHealth; Health technology assessment; Healthcare economics; Hypoglycemia; Insulin therapy; Type 1 diabetes
Diabetes Ther
DIGITAL FEATURES Key Summary Points Why carry out this study? Digital health solutions are becoming increasingly established for chronic disease management, particularly in the treatm
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