Cost-Utility Analysis of the MiniMed™ 780G Advanced Hybrid Closed-Loop System Versus Intermittently Scanned...

Background and Aims: Advanced hybrid closed-loop (AHCL) automated insulin delivery systems such as the MiniMed™ 780G have been shown to result in substantial improvements in disease management in people living with type 1 diabetes. The aim of the analysis was to assess the cost utility of the MiniMed 780G system compared with intermittently scanned continuous glucose monitoring (is-CGM) and multiple daily insulin injections (MDI) in people living with type 1 diabetes in France, to estimate the incremental cost-utility ratio (ICUR) and inform decision-making. Methods: The analysis was performed using the CORE Diabetes Model (version 9.5) and clinical input data were sourced from a randomized controlled trial, with glycated hemoglobin reductions of 1.54% (16.8 mmol/mol) and 0.2% (2.18 mmol/mol) assumed for the MiniMed 780G arm and is-CGM + MDI arm, respectively. The analysis was conducted from a national payer perspective over a 40-year time horizon; future costs and clinical outcomes were discounted at 2.5% per annum. Results: In the base case analysis, use of the MiniMed 780G system was associated with a mean gain in quality-adjusted life expectancy of 2.26 quality-adjusted life years (QALYs) compared with is-CGM + MDI (16.33 QALYs vs. 14.07 QALYs), while mean direct lifetime costs were EUR 78,509 higher (EUR 215,037 vs. EUR 136,528), resulting in an ICUR of EUR 34,732 per QALY gained. Findings from sensitivity analyses showed that analyses were robust to changes in assumptions in most input parameters. Conclusions: In people with type 1 diabetes in France not achieving glycemic target levels at baseline, the use of the MiniMed 780G system was projected to lead to substantial improvements in quality-adjusted life expectancy compared with continued use of is-CGM + MDI, with an ICUR of EUR 34,732 per QALY gained.