Objective: A simulation study assessed cost-effectiveness of the MiniMed™ 780G system (MM780G) compared to MDI used with Dexcom G6 CGM (MDI+G6) in people with T1D in the United States.
Methods: The IQVIA Core Diabetes Model was used to estimate costs and quality of life over a lifetime horizon. Demographic and clinical characteristics were sourced from a 6-month randomized controlled trial1. The cohort had an age (mean±SD) of 45.4±13.3 years, was 62.5% male, and had an A1C of 8.9%±0.5% at baseline. Total daily dose (TDD) of insulin at baseline differed between groups (52.8±29.1 for MM780G vs. 79.2±47.1 for MDI+G6). After 6 months, MM780G reduced A1C by 1.7±1.0% and MDI+G6 by 0.6±1.3%. Rates of hypoglycemia with MDI + real-time CGM therapy were taken from the literature and, also, used as rates of hypoglycemia for the MM780G. One-way sensitivity analyses were performed to assess the impact of model assumptions, and cost-effectiveness acceptability curves were used to find the probability of cost-effectiveness at a commonly accepted willingness-to-pay (WTP) threshold ($150,000).
Results: The base case results show that MM780G was associated with increased quality-adjusted life expectancy (QALE) compared to MDI+G6 (11.31±0.15 years for MM780G vs. 10.34±0.13 for MDI+G6), as well as increased costs ($453,962 ± $10,858 for MM780G vs. $363,470 ± $10,736 for MDI+G6). The incremental cost-effectiveness ratio (ICER) was $92,917 per QALE, which has a 96.3% probability of being cost-effective at the WTP threshold. Assuming the same TDD between groups, analyses determined that MM780G was associated with an ICER of $136,189 per QALE and a 67.7% probability of being cost effective.
Conclusions: At a WTP threshold of $150,000, MM780G is cost effective in T1D versus therapy with MDI + Dexcom G6, in the United States.
Reference:
1. van den Heuvel T, et al. J Diabetes Sci Technol. 2023; doi:10.1177/19322968231161320.
M. Kommareddi: Employee; Medtronic. R.A. Vigersky: Employee; Medtronic.
