Objective: To assess cost-effectiveness of the MiniMed™ 780G (MM780G) system compared to MDI paired with isCGM when used by people with T1D in Singapore, in a simulation study.

Methods: The IQVIA Core Diabetes Model was used to estimate complications, costs, and quality of life over a lifetime among a cohort of people with T1D in Singapore. Change in HbA1c was sourced from a 6-month randomized controlled trial (ClinicalTrials.gov, NCT04235504). Demographic characteristics and baseline HbA1c were gathered from local databases. Cost inputs were derived from the literature and localized data. The cohort assumed a mean age of 32.2±15.9 years, was 76% female and had a HbA1c of 8.4%±1.84% at baseline. HbA1c was reduced by 1.5±0.7% with MM780G and by 0.2±0.8% with MDI + isCGM, after 6 months. Rates of hypoglycemia and diabetic ketoacidosis were taken from the literature for the MDI + isCGM group and were assumed to be 0% in MM780G patients based on trial results. Probabilistic sensitivity analysis was conducted to assess the impact of parameter uncertainty and model assumptions.

Results: MM780G was associated with increased quality-adjusted life years (QALY) compared to MDI + isCGM (13.03±0.16 years for MM780G vs. 12.00±0.14 for MDI + isCGM), alongside increased costs (SGD 256,289 ± SGD 4,525 for MM780G vs. SGD 209,237 ± SGD 4,217 for MDI + isCGM). The incremental cost-effectiveness ratio (ICER) in the base case was SGD 45,483 per QALY. The probabilistic sensitivity analysis indicated a 60.0% probability that MM780G is cost-effective compared to MDI + isCGM in T1D, at a willingness-to-pay (WTP) threshold of SGD 45,000 (USD $33,300) per QALY.

Conclusions: At a WTP threshold of SGD 45,000 per QALY, MM780G is cost-effective compared to MDI + isCGM in a population of people with T1D in Singapore.

Disclosure

D.Gardner: None. M.Lakkad: None. Z.Qiu: Employee; Medtronic. Y.Inoue: Employee; Medtronic. S.Rama chandran: Advisory Panel; Medtronic, Dexcom, Inc., Speaker's Bureau; Medtronic, Abbott, Boehringer Ingelheim Inc., Sanofi, AstraZeneca. K.Wherry: Employee; Medtronic, Stock/Shareholder; Medtronic.

© 2023 by the American Diabetes Association
2023
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