Cost-Effectiveness of Control-IQ+ Technology in Insulin-Treated Patients With Type 2 Diabetes in the United States

Automated insulin delivery (AID) has been established as an effective therapy for individuals with type 1 diabetes. This analysis evaluates the clinical and economic outcomes of AID compared with multiple daily injections plus continuous glucose monitoring (MDI/CGM) in adults with type 2 diabetes.

The IQVIA CORE Diabetes Model v10.0 was employed to simulate the impact of using the t:slim X2 insulin pump with Control-IQ+ technology (Control-IQ+) versus MDI/CGM over a 50-year period using data from the 2IQP randomized controlled trial (NCT05785832). Trial data informed cohort demographics, intervention effects and resource utilization while literature sources provided health state utilities and costs. Scenario analyses examined the effect of Control-IQ+ on reducing HbA1c based on alternative HbA1c progression estimates from the Swedish National Diabetes Registry and alternative resource use and treatment effects from real-world evidence.

The base case analysis indicated that direct medical costs per individual for type 2 diabetes management with Control-IQ+ were $239 935 compared to $209 792 with MDI/CGM use. Control-IQ+ resulted in 0.51 additional quality-adjusted life years (QALYs: 10.36 vs. 9.85 for MDI/CGM), yielding an incremental cost-effectiveness ratio (ICER) of $59 417 per QALY, 95% CI: ($55 836, $62 998). In probabilistic sensitivity analyses, 89% of simulations produced ICERs below $100 000/QALY. ICERs across all scenarios remained below $100 000 per QALY.

Control-IQ+ is associated with increased life expectancy, higher QALYs and reduced complication rates. These findings suggest that Control-IQ+ is cost-effective relative to MDI/CGM for managing patients with type 2 diabetes in the United States.