Abstract
Objective: A simulation study assessed cost-effectiveness of the MiniMed 780G (MM780G) system compared to MDI paired with isCGM devices in people with T1D. Methods: The IQVIA Core Diabetes Model was used to estimate complications, costs, and quality of life over patients’ lifetimes. Demographic and clinical characteristics were sourced from a 6-month randomized controlled trial (ClinicalTrials.gov, NCT04235504). The cohort had a mean±SD age of 41.5±11.6 years, was 46% male, and had an A1C of 9.0%±0.97% at baseline. The MM780G reduced A1C by 1.5±0.7% after 6 months, compared to a 0.2±0.8% reduction by MDI + isCGM. Rates of hypoglycemia and diabetic ketoacidosis were taken from the literature for the MDI + isCGM group and were assumed to be 50% lower in MM780G patients. Probabilistic sensitivity and scenario analyses were conducted to assess the impact of parameter uncertainty and model assumptions. Results: Results from the base case indicate that MM780G was associated with increased quality-adjusted life expectancy (QALE) compared to MDI + isCGM (10.75±0.14 years for MM780G vs. 9.61±0.12 for MDI + isCGM), as well as increased costs ($544,509 ± $17,464 for MM780G vs. $438,551 ± $16,307 for MDI + isCGM). The incremental cost-effectiveness ratio (ICER) in the base case was $93,595 per QALE. The probabilistic sensitivity analysis indicates a 96.6% probability that MM780G is cost-effective compared to MDI + isCGM in T1D at a willingness-to-pay (WTP) threshold of $150,000 per QALE. The scenario, assuming a 25% treatment effect for hypoglycemia and diabetic ketoacidosis, found that MM780G was associated with an ICER of $128,990 per QALE, and a 70.5% probability of cost-effectiveness compared to MDI + isCGM at a WTP threshold of $150,000. Conclusions: At a WTP threshold of $150,000, MM780G is cost-effective in T1D compared to MDI + isCGM. Disclosure M.Kommareddi: Employee; Medtronic. K.Wherry: Employee; Medtronic, Stock/Shareholder; Medtronic.
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