Background: Young adults with type 1 diabetes (T1D) experience significant difficulties adhering to glucose control standards. An innovative care model - shared medical appointments through home telemedicine - was recently examined and found to improve patient attendance and diabetes care engagement.

Objective: To evaluate within-trial cost-effectiveness of the intervention in Colorado Young adults with T1D (CoYoT1) aged 18-25.

Methods: In the prospective pilot trial, patients self-selected into the CoYoT1 or usual care groups. We collected baseline, 6, and 12 months data on patients’ self-reported healthcare use and trial medical care time related to group and/or individual visits.

Results: The health-related utility in the control group declined to a greater extent than the CoYoT1 group (p=0.04), but QALYs did not differ between the groups (p=0.5). We also found significantly lower direct, indirect, and total costs during the trial (CoYoT1: $2,341 vs. control: $6,935) (all p <0.01). The benefits were mainly due to CoYoT1 patients having fewer hospitalizations (p=0.09) and fewer primary care visits that occurred outside the trial (p=0.01), although the CoYoT1 group ($199) had higher annual costs of trial medical care time than controls ($84).

Conclusion: With long-term implementation, the CoYoT1 intervention may help patients to maintain a higher quality of life and save overall healthcare costs.

W. Wan: None. R. Skandari: None. A. Nathan: None. P. Zarei: None. M.W. Reid: None. J. Raymond: None. E. Huang: None.

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