Clinical and economic benefits of integrated pump/CGM technology therapy in patients with type 1 diabetes in Colombia.
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.
Hospital Universitario de San Ignacio-Universidad Javeriana, Bogotá, Colombia. Electronic address: amgomezm5@gmail.com.
Ana Maria
AM
Gomez
University of Washington, Seattle, WA, EE. UU.; RANDOM Foundation, Bogotá, Colombia.
Rafael
R
Alfonso-Cristancho
Medtronic PLC Andean Region, Bogotá, Colombia.
John Jairo
JJ
Orozco
Medtronic Diabetes Inc., Northridge, CA, EE. UU.
Peter Matthew
PM
Lynch
University of Washington, Seattle, WA, EE. UU.
Diana
D
Prieto
Ossian Health Economics and Communications, Basilea, Suiza.
Rhodri
R
Saunders
HEVA HEOR, Lyon, Francia.
Stephane
S
Roze
Medtronic Latinamerica Inc., Miami, FL, EE. UU.
Juan Esteban
JE
Valencia
D000293:Adolescent; D000328:Adult; D015190:Blood Glucose Self-Monitoring / Q000191:economics / Q000379:methods*; D003105:Colombia; D003362:Cost-Benefit Analysis; D048909:Diabetes Complications / Q000191:economics / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000191:economics; D018450:Disease Progression; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007279:Injections, Subcutaneous; D007332:Insulin Infusion Systems / Q000191:economics; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D008954:Models, Biological; D055815:Young Adult
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