Cost‐effectiveness analysis comparing advanced hybrid closed‐loop automated insulin delivery with multiple daily insulin injections and continuous glucose monitoring in adults with type 1 diabetes in Japan

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Abstract
Aim: The use of automated insulin delivery systems, including the MiniMed™ 780G advanced hybrid closed‐loop system, has been shown to improve glycemic management in people with type 1 diabetes (T1D). The aim was to assess the cost‐effectiveness of the MiniMed 780G system versus multiple daily injections (MDI) of insulin in combination with continuous glucose monitoring (CGM) in the management of people with T1D with elevated HbA1c levels in Japan. Methods: Modeling was performed using the IQVIA Core Diabetes Model and clinical input data were sourced from a randomized controlled trial. A time horizon of 55 years, a discount rate of 2.0% per annum, and a payer perspective were used. Sensitivity analyses were used to examine the robustness of base‐case results. Results: In the base‐case, an incremental cost‐effectiveness ratio (ICER) of JPY 4,723,991 per quality‐adjusted life year (QALY) gained was found, with an incremental benefit of 2.83 quality‐adjusted life years with the MiniMed 780G system versus MDI + CGM. The MiniMed 780G system was therefore cost‐effective, assuming a willingness‐to‐pay threshold of JPY 5,000,000 per QALY. Although treatment costs were found to be JPY 16,226,167 higher for the MiniMed 780G, costs associated with managing long‐term complications were lower. A probabilistic sensitivity analysis found the intervention to have a 76.9% probability of being cost‐effective in Japan. Conclusion: The MiniMed 780G system was projected to be cost‐effective in the management of people with T1D in Japan with HbA1c above target levels. Its use was also predicted to improve clinical outcomes when compared with MDI + CGM.

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